CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Putnam County Hospital

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 470
Insurance Median: $10,492
Cash Discount Price: $37,986
vs. Medicare Baseline: 0.75x Medicare

The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at Putnam County Hospital is $10,492. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $37,986. Compared to the federal Medicare reimbursement reference rate of $14,044.15, this hospital’s rate is 0.75x the Medicare baseline. Located in 1542 S Bloomington St, Greencastle, IN.

Cash / Self-Pay

$37,986

Average discount available for prompt cash payment at this facility.

Insurance Median

$10,492

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$14,044.15

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $14,044.15 (100%)

Cash / Self-Pay: $37,986 (270%)

Insurance Median: $10,492 (75%)

Cash: $37,986 (270% of Medicare)

Ins. Median: $10,492 (75% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $14,044.15 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
UnitedHealthcare	$2,434	17%
Blue Cross Blue Shield	$2,581 - $12,357	18%
Caresource Just4Me - All Other Plans	$3,082	22%
Caresource Mcr Advantage	$3,082	22%
Humana	$3,082 - $36,882	22%
Indiana Univeristy Qhp	$10,570	75%
Indiana University Plan	$10,570	75%
Caresource Hip Mcaid	$12,813	91%
Caresource Hoosier Healthwise	$12,813	91%
Sagamore Health Ip-All Plans	$38,880	277%
Cigna	$41,115	293%
Aetna	$42,455	302%
Encore-All Plans	$42,455	302%
Indiana Health Network Ip-All Other Plans	$43,349	309%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $37,986.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify MS-DRG Code matches exactly: 470.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Putnam County Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for MS-DRG code 470.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.