Hip or knee replacement (inpatient stay)
Facility: Rehabilitation Hospital Of Overland Park
Billing Code: 470 (MS-DRG)
- CPT Billing Code: 470
- Insurance Median: $8,892
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.63x 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 |
|---|---|---|
| United | $8,892 | 63% |
| Healthy Blue Kansas | $8,892 | 63% |
| Aetna | $8,892 | 63% |
| Medicaid / KanCare | $8,892 | 63% |
Consumer Guidance & Cost Commentary
For the procedure "Hip or knee replacement (inpatient stay)" at the Rehabilitation Hospital Of Overland Park in Overland Park, KS, the facility's negotiated rate is $8,892. This amount is identical to the cash median, meaning there is no price difference between paying out-of-pocket and using insurance for this specific service. While commercial payers like United, Healthy Blue Kansas, Aetna, and Medicaid/KanCare all utilize this same negotiated rate, patients should be aware that cash-pay options can sometimes be cheaper than insurance for those with high-deductible plans if the insurer's allowed amount exceeds the cash price. Since the cash and negotiated rates are equal here, there is no financial advantage to paying cash directly, but it is always advisable to ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling to ensure you are receiving the lowest possible rate.
This facility operates as a Part A Provider - Hospital and its pricing is benchmarked against the Medicare rate of $14,044.15. The negotiated rate of $8,892 represents a significant reduction compared to the Medicare amount, aligning with fair pricing principles that typically fall between 120% and 150% of Medicare, whereas commercial rates often average 200% to 300%. Because the facility is in-network for all listed payers, patients are protected from balance billing for emergency care and non-emergency services at this location under the No Surprises Act. However, if you receive a bill that appears higher than expected, you should request a detailed itemized audit to verify that no unbundled codes or services not rendered have inflated the total, as over