CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Jefferson Stratford Hospital

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 470
Insurance Median: $20,160
Cash Discount Price: $20,583
vs. Medicare Baseline: 1.44x Medicare

The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at Jefferson Stratford Hospital is $20,160. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $20,583. Compared to the federal Medicare reimbursement reference rate of $14,044.15, this hospital’s rate is 1.44x the Medicare baseline. Located in 18 East Laurel Road, Stratford, NJ.

Cash / Self-Pay

$20,583

Average discount available for prompt cash payment at this facility.

Insurance Median

$20,160

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: $20,583 (147%)

Insurance Median: $20,160 (144%)

Cash: $20,583 (147% of Medicare)

Ins. Median: $20,160 (144% 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
Tricare	$18,327	130%
St Agnes	$18,327	130%
Point of Comfort Refugee Resettlement	$18,327	130%
Inspira Life	$18,327	130%
Medicare (plans)	$18,327 - $18,887	130%
UnitedHealthcare	$18,327 - $19,793	130%
Aetna	$18,694 - $43,434	133%
Humana	$18,694	133%
Innovage	$18,694	133%
Cigna	$19,060 - $40,125	136%
Devoted Health Participation	$19,243	137%
Blue Cross Blue Shield	$19,351 - $24,763	138%
Provider Partners Health Plan	$19,610	140%
Highmark Wholecare Gateway	$20,160	144%
Allwell PA Health_Wellness Ma	$20,160	144%
Geisinger Health Plan	$20,542 - $67,278	146%
Ibc Employee Benefit	$22,909	163%
Ibc Main Line Health	$22,909	163%
Ambetter / Centene	$23,400	167%
Jeff Nj Amerihealth_Ibc	$25,236 - $33,940	180%
Highmark	$29,197 - $36,177	208%
Naphcare	$29,323	209%

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 $20,583.
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 Jefferson Stratford 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.