Hip or knee replacement (inpatient stay)
Facility: Amberwell Atchison Association
Billing Code: 470 (MS-DRG)
- CPT Billing Code: 470
- Insurance Median: $12,884
- Cash Discount Price: $38,984
- vs. Medicare Baseline: 0.92x 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 |
|---|---|---|
| Multiplan - All Plans | $2,710 | 19% |
| Superior Select Mcr Adv - All Plans | $3,752 | 27% |
| Va Ccn - All Plans | $3,752 | 27% |
| Triwest - All Plans | $3,752 | 27% |
| Humana | $3,752 - $20,090 | 27% |
| UnitedHealthcare | $3,752 - $12,884 | 27% |
| Ambetter / Centene | $5,816 | 41% |
| Blue Cross Blue Shield | $21,044 - $22,152 | 150% |
| Cigna | $21,441 | 153% |
| Aetna | $26,867 | 191% |
| Oscar - All Plans | $29,238 | 208% |
| Centrus Health Direct - All Plans | $31,187 | 222% |
| Wppa Providrs Care - All Plans | $35,086 | 250% |
Consumer Guidance & Cost Commentary
For a hip or knee replacement at Amberwell Atchison Association in Atchison, KS, the cash median price is $38,984, which matches the facility's gross charge. While this cash rate is significantly higher than the state average for this procedure, it is important to note that commercial insurance negotiated rates often exceed the cash price due to administrative overhead and contract structures. For instance, UnitedHealthcare's highest negotiated rate is $12,884, yet their average allowed amount is $25,340, which is still lower than the cash price. Patients with high-deductible plans or those who have not yet met their out-of-pocket maximum may find paying the cash rate directly more cost-effective than relying on insurance, as the insurer's allowed amount could still surpass the self-pay price.
To minimize unexpected costs, patients should actively request a "self-pay" or "prompt-pay" discount before scheduling, as these upfront payment incentives can reduce the total bill by 20% to 50%. Additionally, if you are using insurance, be aware that balance billing is generally prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act, though unexpected charges can still occur from out-of-network ancillary services like specific lab tests or emergency physicians. If you receive a bill, always demand a full itemized statement to verify that no services were unbundled or that charges were rendered, as over 80% of hospital bills contain errors that can be corrected through a formal written audit dispute.