Hip or knee replacement (inpatient stay)
Facility: Jefferson Lansdale Hospital
Billing Code: 470 (MS-DRG)
- CPT Billing Code: 470
- Insurance Median: $15,975
- Cash Discount Price: $15,439
- vs. Medicare Baseline: 1.14x 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 |
|---|---|---|
| Medicare (plans) | $13,200 - $15,838 | 94% |
| Jefferson Health Plan Aca Qhp Exchange | $13,248 | 94% |
| Inspira Life | $13,772 | 98% |
| Point Of Comfort Refugee Resettlement | $13,772 | 98% |
| Provider Partners Health Plan | $13,772 | 98% |
| Tricare | $13,772 | 98% |
| UnitedHealthcare | $13,772 - $27,768 | 98% |
| Humana | $14,047 | 100% |
| Innovage | $14,047 | 100% |
| Cigna | $14,323 - $36,121 | 102% |
| Devoted Health Participation | $14,460 | 103% |
| Aetna | $14,598 - $31,288 | 104% |
| Keystone First Vip Choice | $14,598 | 104% |
| Allwell Pa Health_Wellness Ma | $15,149 | 108% |
| Highmark Wholecare Gateway | $15,149 | 108% |
| St Agnes | $15,405 | 110% |
| Perennial | $15,975 | 114% |
| Ibc Employee Benefit | $17,215 | 123% |
| Ibc Main Line Health | $17,215 | 123% |
| Ibc | $20,251 - $27,496 | 144% |
| Ambetter / Centene | $20,646 | 147% |
| Naphcare | $22,035 | 157% |
| Highmark | $23,351 - $28,932 | 166% |
| Blue Cross Blue Shield | $26,148 - $28,160 | 186% |
| Upmc Commercial | $36,121 | 257% |
| Geisinger Health Plan | $67,278 | 479% |