CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Saint Luke's East Hospital

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 470
Insurance Median: $22,563
Cash Discount Price: $47,399
vs. Medicare Baseline: 1.61x Medicare

The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at Saint Luke's East Hospital is $22,563. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $47,399. Compared to the federal Medicare reimbursement reference rate of $14,044.15, this hospital’s rate is 1.61x the Medicare baseline. Located in 100 N E Saint Luke's Boulevard, Lees Summit, MO.

Cash / Self-Pay

$47,399

Average discount available for prompt cash payment at this facility.

Insurance Median

$22,563

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: $47,399 (337%)

Insurance Median: $22,563 (161%)

Cash: $47,399 (337% of Medicare)

Ins. Median: $22,563 (161% 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
Cigna	$1,777 - $45,020	13%
Humana	$2,200	16%
Transplants-Case Rates [5750]	$2,200 - $83,173	16%
Blue Cross Blue Shield	$3,360 - $67,376	24%
Commercial-Contracted [8000]	$5,014 - $21,999	36%
Medicaid / KanCare	$11,434 - $11,891	81%
Medicare (plans)	$13,750 - $14,437	98%
UnitedHealthcare	$23,126 - $31,285	165%
Aetna	$30,170 - $59,838	215%

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 $47,399.
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 Saint Luke's East 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.