CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Anmed Health

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 470
Insurance Median: $11,193
Cash Discount Price: $47,717
vs. Medicare Baseline: 0.80x Medicare

The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at Anmed Health is $11,193. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $47,717. Compared to the federal Medicare reimbursement reference rate of $14,044.15, this hospital’s rate is 0.80x the Medicare baseline. Located in 800 N Fant St, Anderson, SC.

Cash / Self-Pay

$47,717

Average discount available for prompt cash payment at this facility.

Insurance Median

$11,193

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: $47,717 (340%)

Insurance Median: $11,193 (80%)

Cash: $47,717 (340% of Medicare)

Ins. Median: $11,193 (80% 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
Cigna	$8,569 - $11,193	61%
Nalc Health Benefit Plan [291]	$8,569	61%
Absolute Total Care Mcr Plans Alt Payer [4101]	$11,193	80%
Absolute Total Care Mcr Plans [41]	$11,193	80%
Aetna	$11,193	80%
Ambetter / Centene	$11,193	80%
Blue Cross Blue Shield	$11,193 - $50,386	80%
Bright Health Alt Payer [1001]	$11,193	80%
Champva [604]	$11,193	80%
Continental Life Ins Co [7]	$11,193	80%
Devoted Health Alt Payer [9401]	$11,193	80%
Devoted Health [94]	$11,193	80%
Edison Health Solutions [95]	$11,193	80%
First Choice Next [96]	$11,193	80%
First Choice Vip Careplus Alt Payer [3301]	$11,193	80%
First Choice Vip [33]	$11,193	80%
Healthscope [98]	$11,193	80%
Humana	$11,193	80%
Medicare (plans)	$11,193	80%
Molina Dual Options [15]	$11,193	80%
Molina Marketplace [97]	$11,193	80%
Mutual Of Omaha [107]	$11,193	80%
Nhc Advantage Alt Payer [6101]	$11,193	80%
Nhc Advantage [61]	$11,193	80%
Tricare	$11,193	80%
UnitedHealthcare	$11,193 - $60,956	80%
Vaccn - Va Community Care Network [16]	$11,193	80%
Veterans Administration [633]	$11,193	80%
Workers Compensation [622]	$11,193	80%
Bright Health [11]	$28,282	201%
Blue Choice Health Plan [922]	$29,949 - $55,143	213%
Planned Administrators [886]	$50,386	359%
Thomas Cooper & Company [315]	$50,386	359%
Geha [302]	$60,956	434%
Golden Rule Ins Co [584]	$60,956	434%

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 $47,717.
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 Anmed Health 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.