CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Novant Health Hilton Head Medical Center

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 470
  • Insurance Median: $18,071
  • Cash Discount Price: $26,077
  • vs. Medicare Baseline: 1.29x Medicare
The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at Novant Health Hilton Head Medical Center is $18,071. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $26,077. Compared to the federal Medicare reimbursement reference rate of $14,044.15, this hospital’s rate is 1.29x the Medicare baseline. Located in 25 Hospital Center Blvd, Hilton Head Island, SC.
Cash / Self-Pay
$26,077

Average discount available for prompt cash payment at this facility.

Insurance Median
$18,071

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: $26,077 (186%)
Insurance Median: $18,071 (129%)
Cash: $26,077 (186% of Medicare)
Ins. Median: $18,071 (129% 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
Absolute Total Care $17,210 - $30,118 123%
Aetna $17,210 123%
Devoted Health Plan $17,210 123%
Humana $17,210 123%
UnitedHealthcare $17,210 - $99,402 123%
Molina $17,554 - $30,118 125%
Cigna $17,727 126%
Clover Insurance Company $17,899 127%
Select Health $18,071 - $38,551 129%
Blue Cross Blue Shield $26,077 - $52,026 186%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 25 Hospital Center Blvd, Hilton Head Island, SC 29926
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals