CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Christus Ochsner St Patrick Hospital

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 470
Insurance Median: $11,477
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.82x Medicare

The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at Christus Ochsner St Patrick Hospital is $11,477. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $14,044.15, this hospital’s rate is 0.82x the Medicare baseline. Located in 524 Dr Michael Debakey Drive, Lake Charles, LA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$11,477

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$14,044.15

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $14,044.15 (100%)

Insurance Median: $11,477 (82%)

Ins. Median: $11,477 (82% of 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Healthcare Highways	$1,500	11%
Verity Healthnet	$1,500	11%
Aetna	$3,549 - $11,477	25%
Vantage Health Plan Inc.	$3,961 - $31,518	28%
Five Point Credit Union	$4,190 - $10,056	30%
Multiplan	$9,371	67%
Phcs	$9,371	67%
Triwest	$11,248	80%
Arcadian	$11,477	82%
Blue Cross Blue Shield	$11,477 - $28,633	82%
Christus Health	$11,477 - $16,068	82%
Coventry	$11,477	82%
Humana	$11,477 - $27,723	82%
UnitedHealthcare	$11,477 - $18,817	82%
Vantage Health Plan Inc	$11,477	82%
Dignity Health	$11,822	84%
Peoples Health	$11,822	84%
Wellcare	$12,051	86%
Allyalign Health	$12,625	90%
Medicare (plans)	$12,625	90%
Lsu First Choice Verity	$13,802	98%
Ppo Usa	$20,572	146%
Cigna	$21,974	156%
Gilsbar Inc.	$23,710	169%
Ppoplus Llc	$24,066	171%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $X.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify MS-DRG Code matches exactly: 470.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Christus Ochsner St Patrick Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for MS-DRG code 470.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.