CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: McLaren Greater Lansing

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 470
Insurance Median: $18,448
Cash Discount Price: $36,497
vs. Medicare Baseline: 1.31x Medicare

The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at McLaren Greater Lansing is $18,448. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $36,497. Compared to the federal Medicare reimbursement reference rate of $14,044.15, this hospital’s rate is 1.31x the Medicare baseline. Located in 2900 Collins Road, Lansing, MI.

Cash / Self-Pay

$36,497

Average discount available for prompt cash payment at this facility.

Insurance Median

$18,448

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: $36,497 (260%)

Insurance Median: $18,448 (131%)

Cash: $36,497 (260% of Medicare)

Ins. Median: $18,448 (131% 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	$13,351	95%
Medicare (plans)	$17,930 - $28,689	128%
Tricare	$18,448	131%
Mi Amish Medical Board	$20,620	147%
Blue Cross Blue Shield	$28,253	201%
Cofinity Auto	$34,068	243%

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 $36,497.
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 McLaren Greater Lansing 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.