CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: University Health Lakewood Medical Center

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 470
Insurance Median: $12,078
Cash Discount Price: $28,750
vs. Medicare Baseline: 0.86x Medicare

The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at University Health Lakewood Medical Center is $12,078. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $28,750. Compared to the federal Medicare reimbursement reference rate of $14,044.15, this hospital’s rate is 0.86x the Medicare baseline. Located in 7900 Lee's Summit Rd, Kansas City, MO.

Cash / Self-Pay

$28,750

Average discount available for prompt cash payment at this facility.

Insurance Median

$12,078

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: $28,750 (205%)

Insurance Median: $12,078 (86%)

Cash: $28,750 (205% of Medicare)

Ins. Median: $12,078 (86% 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	$1,600 - $11,384	11%
Aetna	$2,217 - $11,384	16%
UnitedHealthcare	$2,591 - $23,416	18%
Blue Cross Blue Shield	$11,384 - $47,184	81%
Home State	$11,384	81%
Provider Partners	$11,384	81%
Ambetter / Centene	$12,978	92%
Cigna	$15,493	110%
Oscar Exchange	$17,724	126%

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 $28,750.
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 University Health Lakewood Medical Center 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.