Hip or knee replacement (inpatient stay)
Facility: Centura St. Catherine-Dodge City
Billing Code: 470 (MS-DRG)
- CPT Billing Code: 470
- Insurance Median: $14,147
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.01x 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 |
|---|---|---|
| Cigna | $14,147 | 101% |
| Kaiser | $14,147 | 101% |
| Blue Cross Blue Shield | $14,147 - $26,042 | 101% |
| Kansas Health | $14,147 | 101% |
| Medicare (plans) | $14,147 | 101% |
| Humana | $14,147 | 101% |
| Aetna | $14,147 | 101% |
Consumer Guidance & Cost Commentary
For the procedure code 470, "Hip or knee replacement (inpatient stay)," at Centura St. Catherine-Dodge City in Dodge City, KS, the facility's negotiated rates range from $14,147 to $26,042 depending on the insurance carrier. The median negotiated rate across all payers is $14,147, which aligns closely with the Medicare benchmark of $14,044.15. This indicates that the facility's pricing is consistent with the federal government's cost-based standard for this service. While the facility is a Proprietary Acute Care Hospital, patients should be aware that cash payments are not listed in the current data; however, it is generally advisable to inquire directly with the hospital about "self-pay" or "prompt-pay" discounts, as these upfront incentives can sometimes result in lower total costs than standard insurance negotiated rates.
When reviewing your final invoice, ensure you are looking at an itemized bill rather than a summary statement, as hospitals often use broad categories to obscure individual charges. Since over 80% of hospital bills contain errors, requesting a detailed line-by-line statement is the most effective way to identify unbundled codes or services not rendered. Additionally, while the facility's rates are competitive with Medicare benchmarks, remember that commercial insurance contracts often include administrative overhead that can inflate the baseline price by 20% to 40%. If you have an out-of-network provider involved in your care, the No Surprises Act may protect you from balance billing, but you should verify your specific coverage and any potential discounts before scheduling your appointment.