Hip or knee replacement (inpatient stay)
Facility: Ascension Via Christi Rehabilitation Hospital Inc
Billing Code: 470 (MS-DRG)
- CPT Billing Code: 470
- Insurance Median: $19,908
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.42x 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 |
|---|---|---|
| Medica | $10,731 | 76% |
| Aetna | $12,420 - $18,538 | 88% |
| Healthchoice Of Ok | $21,277 | 152% |
| UnitedHealthcare | $21,783 - $22,150 | 155% |
| Smarthealth | $24,133 | 172% |
| Humana | $25,665 | 183% |
Consumer Guidance & Cost Commentary
For a hip or knee replacement procedure at Ascension Via Christi Rehabilitation Hospital Inc in Wichita, KS, the facility's negotiated rates range from $10,731 to $25,665 depending on your specific insurance carrier. While the median negotiated rate across payers is $19,908, this figure often exceeds the actual cash price, which can be a significant factor for patients with high-deductible plans. In such cases, paying cash directly may result in lower out-of-pocket costs compared to the amount your insurance would allow to pay, provided you qualify for the facility's self-pay or prompt-pay discounts. It is crucial to verify these cash rates and potential discounts with the hospital before scheduling, as waiting until after a claim is submitted can inadvertently void eligibility for these fee reductions.
This procedure is classified as an inpatient stay under MS-DRG code 470, and the facility's pricing is benchmarked against the federal Medicare rate of $14,044.15. The data indicates a 40% markup relative to the Medicare amount, which aligns with typical commercial pricing structures where administrative costs and contract dynamics inflate the baseline price. Because over 80% of hospital bills contain errors, patients should request a detailed, itemized statement before agreeing to any payment plan to ensure no unbundled charges or services not rendered are included. If you receive a balance bill for out-of-network ancillary services, you may be entitled to protections under the No Surprises Act, and you should dispute any unexpected charges in writing rather than accepting summary invoices as final.