Hip or knee replacement (inpatient stay)
Facility: Kingman Healthcare Center
Billing Code: 470 (MS-DRG)
- CPT Billing Code: 470
- Insurance Median: $3,520
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.25x 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 |
|---|---|---|
| Medicaid / KanCare | $3,200 - $7,498 | 23% |
| UnitedHealthcare | $3,200 | 23% |
| Celtic Insurance Company | $3,200 - $3,520 | 23% |
| Wellcare | $3,200 | 23% |
| Humana | $3,200 | 23% |
| Ambetter / Centene | $3,520 | 25% |
| Healthy Blue | $7,498 | 53% |
| Blue Cross Blue Shield | $22,152 | 158% |
Consumer Guidance & Cost Commentary
For a hip or knee replacement at Kingman Healthcare Center in Kansas, the negotiated rates for in-network payers range from $3,200 to $7,498, with a median negotiated amount of $3,520. This facility, a Critical Access Hospital, offers significantly lower rates than the highest commercial payer, Blue Cross Blue Shield, which has a fixed rate of $22,152. While the data does not provide a specific cash or self-pay price, patients with high-deductible plans should be aware that paying cash upfront can sometimes result in lower out-of-pocket costs if the insurance negotiated rate exceeds the cash price. It is essential to contact the hospital directly to confirm their "self-pay" or "prompt-pay" discount programs before scheduling, as these upfront incentives can bypass the administrative costs associated with insurance billing cycles.
The facility's pricing is benchmarked against the federal Medicare rate of $14,044.15, which serves as an objective baseline for healthcare costs. Commercial negotiated rates often include administrative markups that can inflate the final price, whereas Medicare rates reflect the true cost of delivery plus a small margin. Consumers should avoid comparing discounts to the hospital's inflated chargemaster list, as this can make the savings appear larger than they actually are. Instead, the most effective way to understand the value of the care is to compare the facility's rates directly to the Medicare amount. If you receive a bill that appears higher than expected, you have the right to request a detailed, itemized audit to identify any errors, unbundled codes, or services not rendered, ensuring you are only paying for what was actually provided.