CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Jamaica Hospital Medical Center

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 470
  • Insurance Median: $27,898
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.99x Medicare
The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at Jamaica Hospital Medical Center is $27,898. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $14,044.15, this hospital’s rate is 1.99x the Medicare baseline. Located in 89Th Avenue and Van Wyck Expressway, Jamaica, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$27,898

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%)
Insurance Median: $27,898 (199%)
Ins. Median: $27,898 (199% 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.

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
Hotel Trades Council $1,912 14%
World Trade Center Program $2,800 20%
Healthfirst $7,980 - $13,252 57%
Healthfirst - Essential 1/2/200 $13,699 98%
Emblemhealth $27,070 193%
Aetna $27,898 199%
Beacon Health Strategies $27,898 199%
Centerlight Healthcare $27,898 199%
Elderplan $27,898 199%
Empire $27,898 199%
Fidelis $27,898 199%
Ghi $27,898 - $41,720 199%
Hip $27,898 - $34,378 199%
Metroplus $27,898 - $30,688 199%
UnitedHealthcare $27,898 - $29,759 199%
Wellcare Of Ny $27,898 199%
Vns $28,456 203%
Empire - Healthplus D $28,735 205%
Villagecaremax $29,293 209%
Humana $29,712 212%
Hamaspik Choice $30,688 219%
Senior Whole Health $30,688 219%
1999 National Benefit Fund $30,796 219%
Centers Plan For Healthy Living $31,246 222%
Magnacare $32,083 228%
Cigna $33,522 239%
Centivo $35,292 251%
Oscar $36,126 257%
Create Health Plan $44,701 318%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 89Th Avenue and Van Wyck Expressway, Jamaica, NY 11418
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals