Hip or knee replacement (inpatient stay)
Facility: St Charles Medical Center - Bend
Billing Code: 470 (MS-DRG)
- CPT Billing Code: 470
- Insurance Median: $16,774
- Cash Discount Price: $76,358
- vs. Medicare Baseline: 1.19x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Advanced Health [534] | $12,009 | 86% |
| Allcare Health Plan [538] | $12,009 | 86% |
| Cascade Health Alliance [532] | $12,009 | 86% |
| Columbia Pacific Coordinated Care Llc [539] | $12,009 | 86% |
| Health Share Care Oregon [526] | $12,009 | 86% |
| Health Share Kaiser [543] | $12,009 | 86% |
| Health Share Ohsu Ohp [552] | $12,009 | 86% |
| Health Share Providence [548] | $12,009 | 86% |
| Health Share Tuality [549] | $12,009 | 86% |
| Health Share [537] | $12,009 | 86% |
| Intercommunity Health [530] | $12,009 | 86% |
| Jackson Care Connect [542] | $12,009 | 86% |
| Medicaid / KanCare | $12,009 - $15,396 | 86% |
| Primary Health Of Jospehine County Llc [547] | $12,009 | 86% |
| Umpqua Health [533] | $12,009 | 86% |
| Willamette Valley Community Health [536] | $12,009 | 86% |
| Yamhill County Coordinated Care Org [550] | $12,009 | 86% |
| Pacificsource Community Solutions [525] | $12,778 - $14,164 | 91% |
| Aetna | $16,774 | 119% |
| Ageright Advantage [142] | $16,774 | 119% |
| Champ Va [700] | $16,774 | 119% |
| Cigna | $16,774 | 119% |
| Devoted Health Inc [145] | $16,774 | 119% |
| Health Market Care Assured [134] | $16,774 | 119% |
| Health Net Med Adv [135] | $16,774 | 119% |
| Home Health And Hospice [361] | $16,774 | 119% |
| Humana | $16,774 | 119% |
| Indian Health [704] | $16,774 | 119% |
| Kaiser Permanente Med Adv [136] | $16,774 | 119% |
| Law Enforcement [701] | $16,774 | 119% |
| Medicare (plans) | $16,774 - $19,458 | 119% |
| Otj Dept Of Labor Federal Emp [652] | $16,774 | 119% |
| Otj Us Department Of Labor [669] | $16,774 | 119% |
| Samaritan Health Plan Med Adv [141] | $16,774 | 119% |
| Unicare [133] | $16,774 | 119% |
| UnitedHealthcare | $16,774 | 119% |
| Veterans [706] | $16,774 | 119% |
| Wellcare [132] | $16,774 | 119% |
| Blue Cross Blue Shield | $18,452 - $40,127 | 131% |
| Tricare | $18,726 | 133% |
| Kaiser Permanente [334] | $31,032 | 221% |
| Moda [310] | $33,548 | 239% |
| Providence Health Plan [347] | $33,548 | 239% |
| Bridgespan [342] | $34,108 | 243% |
| Asuris Northwest Health [202] | $40,127 | 286% |
| Healthcare Management Admin [201] | $40,127 | 286% |
| Regence Group Administrators [203] | $40,127 | 286% |
| Rx Internal [4100003] | $44,770 | 319% |