CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Munson Healthcare Cadillac Hospital

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 470
  • Insurance Median: $15,200
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.08x Medicare
The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at Munson Healthcare Cadillac Hospital is $15,200. 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 1.08x the Medicare baseline. Located in 400 Hobart St, Cadillac, MI.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$15,200

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: $15,200 (108%)
Ins. Median: $15,200 (108% 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.

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
Cigna $11,176 80%
Priority Health $11,176 - $15,200 80%
Aetna $15,200 108%
American Health Associates $15,200 108%
Autumnwood Of Mcbain Skilled Nursing $15,200 108%
Blue Care Network $15,200 108%
Hap (Health Alliance Plan) $15,200 108%
Humana $15,200 108%
Mclaren Health Plan $15,200 108%
Medicare (plans) $15,200 108%
Michigan Amish Medical Board $15,200 108%
Promedica $15,200 108%
Samaritas Senior Living Skilled Nursing $15,200 108%
UnitedHealthcare $15,200 108%
Wellcare (Meridian) $15,200 108%
Molina $16,416 117%
Employee Benefits Logistics $25,840 184%
Blue Cross Blue Shield $33,728 240%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 400 Hobart St, Cadillac, MI 49601
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals