Hip or knee replacement (inpatient stay)
Facility: Cannon Memorial Hospital
Billing Code: 470 (MS-DRG)
- CPT Billing Code: 470
- Insurance Median: $11,420
- Cash Discount Price: $47,717
- vs. Medicare Baseline: 0.81x 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 |
|---|---|---|
| Cigna | $11,193 | 80% |
| Nhc Advantage Alt Payer [6101] | $11,193 | 80% |
| Nhc Advantage [61] | $11,193 | 80% |
| UnitedHealthcare | $11,193 - $11,420 | 80% |
| Absolute Total Care Mcr Plans Alt Payer [4101] | $11,420 | 81% |
| Absolute Total Care Mcr Plans [41] | $11,420 | 81% |
| Aetna | $11,420 | 81% |
| Ambetter / Centene | $11,420 | 81% |
| Blue Cross Blue Shield | $11,420 - $40,633 | 81% |
| Bright Health Alt Payer [1001] | $11,420 | 81% |
| Champva [604] | $11,420 | 81% |
| Continental Life Ins Co [7] | $11,420 | 81% |
| Devoted Health Alt Payer [9401] | $11,420 | 81% |
| Devoted Health [94] | $11,420 | 81% |
| Edison Health Solutions [95] | $11,420 | 81% |
| First Choice Next [96] | $11,420 | 81% |
| First Choice Vip Careplus Alt Payer [3301] | $11,420 | 81% |
| First Choice Vip [33] | $11,420 | 81% |
| Healthscope [98] | $11,420 | 81% |
| Humana | $11,420 | 81% |
| Medicare (plans) | $11,420 | 81% |
| Molina Dual Options [15] | $11,420 | 81% |
| Molina Marketplace [97] | $11,420 | 81% |
| Mutual Of Omaha [107] | $11,420 | 81% |
| Tricare | $11,420 | 81% |
| Vaccn - Va Community Care Network [16] | $11,420 | 81% |
| Veterans Administration [633] | $11,420 | 81% |
| Workers Compensation [622] | $11,420 | 81% |
| Bright Health [11] | $28,282 | 201% |