Hip or knee replacement (inpatient stay)
Facility: Labette Health
Billing Code: 470 (MS-DRG)
- CPT Billing Code: 470
- Insurance Median: $16,925
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.21x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Uhccp | $7,498 | 53% |
| Medicaid / KanCare | $7,573 - $16,925 | 54% |
| Healthy Blue | $7,648 | 54% |
| Wellcare | $16,925 | 121% |
| UnitedHealthcare | $16,925 - $49,781 | 121% |
| Blue Cross Blue Shield | $16,925 - $22,152 | 121% |
| Humana | $16,925 | 121% |
| Kansas Superior Select | $17,433 | 124% |
| Ambetter / Centene | $19,464 | 139% |
| Montgomery County | $20,224 | 144% |
Consumer Guidance & Cost Commentary
For a hip or knee replacement at Labette Health in Parsons, KS, the average commercial insurance payment is $15,706, which is 20% higher than the Medicare benchmark of $14,044. This rate reflects the facility's negotiated contracts with ten different payers, ranging from $7,498 for Uhccp to $49,781 for UnitedHealthcare. While the facility is government-owned and located in a rural area (Zip 67357), patients should note that cash-pay rates are not listed for this service. In cases where insurance negotiated rates exceed cash prices, paying out-of-pocket can sometimes result in lower total costs, provided the patient has a high deductible plan. It is crucial to verify "self-pay" or "prompt-pay" discounts directly with the hospital before scheduling, as these upfront incentives can significantly reduce the final bill by bypassing administrative claim processing fees.
Although the data does not provide specific county or state average comparisons for this procedure, the wide variance in allowed amounts across payers highlights the importance of understanding your specific plan's negotiated rate. For instance, Medicaid/KanCare plans see an average payment of $15,706, while Wellcare and Humana pay the full negotiated rate of $16,925. If you receive a bill that exceeds the allowed amount for your plan, it may be a result of balance billing from out-of-network ancillary services, though the No Surprises Act generally protects you from such charges for emergency and non-emergency services at in-network facilities. To ensure accuracy, always request a detailed, itemized bill that breaks down every code and charge, as summary invoices