Hip or knee replacement (inpatient stay)
Facility: Overland Park Reg Med Ctr
Billing Code: 470 (MS-DRG)
- CPT Billing Code: 470
- Insurance Median: $15,162
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.08x 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 |
|---|---|---|
| College Park Family Care Center | $2,022 | 14% |
| United | $2,428 - $43,819 | 17% |
| Humana | $4,466 - $15,162 | 32% |
| Multiplan | $6,522 - $14,822 | 46% |
| Medicaid / KanCare | $10,437 | 74% |
| Amerigroup | $12,700 | 90% |
| Healthyblue | $12,954 | 92% |
| Unicare | $13,208 | 94% |
| Aetna | $13,208 - $37,353 | 94% |
| Corvel Corporation | $14,442 | 103% |
| Coventry | $14,934 | 106% |
| Blue Cross Blue Shield | $15,010 - $56,184 | 107% |
| Oha Network | $15,050 | 107% |
| Devoted Health | $15,465 | 110% |
| Wellcare | $15,465 | 110% |
| Celtic | $15,465 | 110% |
| Nhc Advantage | $15,616 | 111% |
| Cigna | $15,768 - $42,953 | 112% |
| Pyramid Life | $16,678 | 119% |
| Universal Healthcare | $16,829 | 120% |
| Oscar | $20,986 | 149% |
| Ambetter / Centene | $21,797 | 155% |
| Wppa Providrs Care Network | $29,705 | 212% |
Consumer Guidance & Cost Commentary
For a hip or knee replacement at Overland Park Reg Med Ctr, the median negotiated rate is $34,562, which is 10% higher than the Medicare benchmark of $14,044. This facility is located in Overland Park, Kansas, and serves 23 different payers, with negotiated rates ranging from $2,022 at College Park Family Care Center to $29,705 at Wppa Providers Care Network. While commercial insurance contracts often cap costs, patients with high-deductible plans may find that paying cash directly is more cost-effective, as the cash price can sometimes be lower than the insurance negotiated rate. It is important to verify your specific plan's deductible status before scheduling, as paying out-of-pocket might result in a lower total cost if your insurance has not yet covered the procedure.
To ensure you are receiving the most accurate pricing, always request a full itemized bill rather than accepting a summary invoice, as hospitals may obscure individual charges. If you receive a balance bill for out-of-network services, remember that the No Surprises Act protects you from paying the difference between the provider's chargemaster and your insurance allowed amount for emergency care and non-emergency services at in-network facilities. Additionally, ask the hospital about prompt-pay discounts, which can reduce your bill by 20% to 50% if you pay in full upfront, bypassing the administrative costs associated with insurance claims processing.