CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Ochsner Rush Hospital

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 470
Insurance Median: $14,863
Cash Discount Price: $15,606
vs. Medicare Baseline: 1.06x Medicare

The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at Ochsner Rush Hospital is $14,863. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $15,606. Compared to the federal Medicare reimbursement reference rate of $14,044.15, this hospital’s rate is 1.06x the Medicare baseline. Located in 1314 19Th Ave, Meridian, MS.

Cash / Self-Pay

$15,606

Average discount available for prompt cash payment at this facility.

Insurance Median

$14,863

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: $15,606 (111%)

Insurance Median: $14,863 (106%)

Cash: $15,606 (111% of Medicare)

Ins. Median: $14,863 (106% 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
Medicaid / KanCare	$10,050 - $15,607	72%
Aetna	$10,359	74%
Cigna	$13,255 - $14,003	94%
UnitedHealthcare	$13,804 - $14,003	98%
Humana	$14,003 - $16,679	100%
Magnolia Health Plan – Wellcare By All Well Of Mississippi	$14,003	100%
Medicare (plans)	$14,020 - $16,103	100%
Shared Health Mississippi	$14,703	105%
Ambetter / Centene	$19,434	138%
Blue Cross Blue Shield	$20,545 - $21,218	146%
Cor Vel	$23,732	169%
Prime Health Services Ppo -Workers Comp	$23,732	169%
Select Administrative Services Network	$28,717 - $37,746	204%
Prime Health Services Ppo	$32,820 - $43,139	234%
Primewell Health Services – Commercial	$34,307	244%
Primewell Health Services Commercial Exchange Plan	$34,658	247%

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 $15,606.
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 Ochsner Rush 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.