CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Our Lady of the Lake Surgical Hospital

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 470
Insurance Median: $17,244
Cash Discount Price: $23,183
vs. Medicare Baseline: 1.23x Medicare

The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at Our Lady of the Lake Surgical Hospital is $17,244. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $23,183. Compared to the federal Medicare reimbursement reference rate of $14,044.15, this hospital’s rate is 1.23x the Medicare baseline. Located in 1700 W Lindberg Drive, Slidell, LA.

Cash / Self-Pay

$23,183

Average discount available for prompt cash payment at this facility.

Insurance Median

$17,244

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%)

Cash / Self-Pay: $23,183 (165%)

Insurance Median: $17,244 (123%)

Cash: $23,183 (165% of Medicare)

Ins. Median: $17,244 (123% 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
Humana	$13,050 - $24,149	93%
UnitedHealthcare	$15,031 - $19,319	107%
Blue Cross Blue Shield	$15,168 - $19,319	108%
Aetna	$16,027 - $19,319	114%
Cigna	$16,668	119%
Triwest	$18,353	131%
Healthy Blue	$19,319	138%
Lhc (Allwell)	$19,319	138%
Peoples Health	$19,319	138%
Vantage Health Plan Inc.	$19,319 - $32,843	138%
Wellcare Health Plan Inc	$19,319	138%
Hs Technology	$38,638	275%

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 $23,183.
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 Our Lady of the Lake Surgical 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.