CMS Price Transparency Data
Hip or knee replacement (inpatient stay)
Facility: Hurley Medical Center
Billing Code: 470 (MS-DRG)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 470
- Insurance Median: $23,841
- Cash Discount Price: $77,873
- vs. Medicare Baseline: 1.70x Medicare
The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at Hurley Medical Center is $23,841. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $77,873. Compared to the federal Medicare reimbursement reference rate of $14,044.15, this hospital’s rate is 1.70x the Medicare baseline. Located in One Hurley Plaza, Flint, MI.
Cash / Self-Pay
$77,873
Average discount available for prompt cash payment at this facility.
Insurance Median
$23,841
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: $77,873 (554%)
Insurance Median: $23,841 (170%)
Cash: $77,873 (554% of Medicare)
Ins. Median: $23,841 (170% 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 |
|---|---|---|
| Humana | $14,247 - $17,744 | 101% |
| Aetna | $15,545 - $22,182 | 111% |
| Amerihealth Caritas Vip Care Plus [7025] | $15,545 | 111% |
| Blue Care Network Advantage [7001] | $15,545 | 111% |
| Blue Cross Blue Shield | $15,545 - $39,054 | 111% |
| Freedom Health Care [7022] | $15,545 | 111% |
| Health Alliance Plan Senior [7003] | $15,545 | 111% |
| Independent Care Health Plan [7015] | $15,545 | 111% |
| Mclaren Advantage [7002] | $15,545 | 111% |
| Medica Healthcare Plan, Inc [7012] | $15,545 | 111% |
| Medicare (plans) | $15,545 - $17,497 | 111% |
| Meridian Complete [7024] | $15,545 | 111% |
| Molina [1071] | $15,545 | 111% |
| Pacificare Of Arizona [7013] | $15,545 | 111% |
| UnitedHealthcare | $15,545 - $23,841 | 111% |
| Wellcare Health Plan [7021] | $15,545 | 111% |
| Zing Health [7028] | $16,089 | 115% |
| Alliance Health And Life [1004] | $17,497 - $23,959 | 125% |
| Allied Benefit Systems [1005] | $17,497 - $22,182 | 125% |
| Allied Insurance [1006] | $17,497 | 125% |
| Ambetter / Centene | $17,497 | 125% |
| Asr Corporation [1007] | $17,497 - $23,959 | 125% |
| Assurant Health [1008] | $17,497 - $22,182 | 125% |
| Automated Benefit Services [1002] | $17,497 | 125% |
| Bankers Life [1009] | $17,497 | 125% |
| Chesterfield Resources [1012] | $17,497 | 125% |
| Coresource [1016] | $17,497 - $22,182 | 125% |
| Generic Commercial [1000] | $17,497 | 125% |
| Globalcare [1024] | $17,497 | 125% |
| Ibew Local 17 [1031] | $17,497 | 125% |
| Jp Farley Corporation [1033] | $17,497 | 125% |
| Managed Health Network [1036] | $17,497 | 125% |
| Meritain Health [1039] | $17,497 | 125% |
| Ngs [1043] | $17,497 | 125% |
| Plumbers Local 98 Insurance Fund [1091] | $17,497 | 125% |
| Teamsters Health And Welfare Fund [1054] | $17,497 | 125% |
| United Behavioral Health [1057] | $17,497 | 125% |
| Us Department Of Labor [5020] | $17,497 | 125% |
| Va Medical Center [1061] | $17,497 | 125% |
| Varipro [1092] | $17,497 | 125% |
| Zelis [1093] | $17,497 | 125% |
| Tricare | $17,744 | 126% |
| Triwest Wps-Vapc3 [1083] | $17,744 | 126% |
| Vha Office Of Community Care [1011] | $17,744 | 126% |
| Geha [1019] | $22,182 | 158% |
| Luminare [1085] | $22,182 | 158% |
| Nippon Life Benefits [1086] | $22,182 | 158% |
| Aarp [1001] | $23,841 | 170% |
| All Savers Insurance [1073] | $23,841 | 170% |
| Golden Rule [1067] | $23,841 | 170% |
| Health Scope Benefits [1082] | $23,841 | 170% |
| United Medical Resources [1059] | $23,841 | 170% |
| Health Alliance Plan [1025] | $23,959 | 171% |
| Cigna | $25,329 | 180% |
| Priority Health Plan [1051] | $25,329 | 180% |
| Bcn Hurley Employee [6007] | $39,054 | 278% |
| Blue Care Network [6005] | $39,054 | 278% |
| Aaa Auto Insurance [8001] | $42,867 | 305% |
| Allstate Auto Insurance [8003] | $42,867 | 305% |
| Auto Owners Auto Insurance [8006] | $42,867 | 305% |
| Bristol West [8007] | $42,867 | 305% |
| Citizens Auto Insurance [8008] | $42,867 | 305% |
| Encompass Insurance [8010] | $42,867 | 305% |
| Esis [8011] | $42,867 | 305% |
| Esurance [8039] | $42,867 | 305% |
| Farm Bureau Auto Insurance [8012] | $42,867 | 305% |
| Farmers Auto Insurance [8013] | $42,867 | 305% |
| Fremont Insurance [8015] | $42,867 | 305% |
| Geico Insurance [8016] | $42,867 | 305% |
| Generic No Fault Auto [8000] | $42,867 - $43,742 | 305% |
| Grange Insurance [8018] | $42,867 | 305% |
| Hanover Insurance [8019] | $42,867 | 305% |
| Hartford Auto Insurance [8021] | $42,867 | 305% |
| Hastings Mutual [8022] | $42,867 | 305% |
| Kemper Insurance [8024] | $42,867 | 305% |
| Liberty Mutual [8025] | $42,867 | 305% |
| Mackinaw Administrators [8040] | $42,867 | 305% |
| Meemic Insurance [8026] | $42,867 | 305% |
| Mitchell Wcs Frankenmuth 135801 [8014] | $42,867 | 305% |
| National General Ins [8017] | $42,867 | 305% |
| Nationwide [8028] | $42,867 | 305% |
| Pioneer State Mutual Auto [8030] | $42,867 | 305% |
| Progressive Auto Insurance [8031] | $42,867 | 305% |
| Safeco-Auto [8037] | $42,867 | 305% |
| State Auto Group [8033] | $42,867 | 305% |
| State Farm Auto Insurance [8034] | $42,867 | 305% |
| Usaa [8036] | $42,867 | 305% |
| Affirmative Insurance [8002] | $43,742 | 311% |
| American Claims Management [8004] | $43,742 | 311% |
| American Fellowship Mutual Insurance [8005] | $43,742 | 311% |
| Cincinnati Insurance Co [8038] | $43,742 | 311% |
| Dairyland Insurance [8009] | $43,742 | 311% |
| Harleysville Insurance [8020] | $43,742 | 311% |
| Horace Mann Insurance [8023] | $43,742 | 311% |
| Michigan Insurance Co Auto [8027] | $43,742 | 311% |
| Northpointe Auto Insurance [8029] | $43,742 | 311% |
| Secura [8032] | $43,742 | 311% |
| Titan Auto Insurance [8035] | $43,742 | 311% |