CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Garden City Hospital

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 470
Insurance Median: $14,707
Cash Discount Price: $17,540
vs. Medicare Baseline: 1.05x Medicare

The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at Garden City Hospital is $14,707. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $17,540. Compared to the federal Medicare reimbursement reference rate of $14,044.15, this hospital’s rate is 1.05x the Medicare baseline. Located in 6245 Inkster Rd, Garden City, MI.

Cash / Self-Pay

$17,540

Average discount available for prompt cash payment at this facility.

Insurance Median

$14,707

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: $17,540 (125%)

Insurance Median: $14,707 (105%)

Cash: $17,540 (125% of Medicare)

Ins. Median: $14,707 (105% 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
Keenan	$7,650	54%
Aetna	$14,707	105%
Blue Cross Blue Shield	$14,707 - $34,912	105%
Harbor Health Plan	$14,707	105%
Honest Hmo	$14,707	105%
Humana	$14,707	105%
Mclaren Health Plan	$14,707	105%
Medicare (plans)	$14,707 - $17,541	105%
Sunrise	$14,707	105%
Total Health Care Priority Health	$14,707	105%
United Behavioral Health	$14,707	105%
Zing	$15,442	110%
Longevity Hp	$15,589	111%
UnitedHealthcare	$17,541	125%
Naphcare Residential Inmate Treatment Center	$22,795	162%
Employer Direct Healthcare	$22,803	162%
Priority Health	$23,041	164%
Tricare	$24,573	175%
National Healthcare Solutions, Inc	$28,065	200%

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 $17,540.
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 Garden City 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.