CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Tennova Healthcare-Jefferson Memorial Hospital

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 470
  • Insurance Median: $13,877
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.99x Medicare
The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at Tennova Healthcare-Jefferson Memorial Hospital is $13,877. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $14,044.15, this hospital’s rate is 0.99x the Medicare baseline. Located in 110 Hospital Drive, Jefferson City, TN.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$13,877

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%)
Insurance Median: $13,877 (99%)
Ins. Median: $13,877 (99% 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
Medicaid / KanCare $1,772 13%
UnitedHealthcare $1,772 - $16,465 13%
Three Rivers Work Comp Tn $1,878 13%
Novanet Work Comp Tn $2,324 17%
Occunet Work Comp Tn $2,347 17%
Tn Work Comp $2,347 17%
Self Pay $6,108 43%
Bluecare $6,186 - $7,725 44%
Amerigroup $7,577 54%
Node Bluecare Plus Tn Mcr Adv $12,499 89%
Humana $13,605 97%
Medicare (plans) $13,605 97%
Node Devoted Health Mcr Adv $13,877 99%
Node Farm Bureau Mcr Adv $13,877 99%
Aetna $14,012 - $17,720 100%
Blue Cross Blue Shield $14,012 - $38,521 100%
Node Healthspring Mcr Adv $14,012 100%
Node Va $14,125 101%
Node Amerigroup Mcr Adv $14,284 102%
Node Wellcare Mcr Adv $14,401 103%
Node Nhc Mcr Adv $14,962 107%
Node Us Dept Of Labor $20,139 143%
Multiplan Complementary $21,805 155%
Ambetter / Centene $25,618 182%
Point Comfort Underwriters $29,932 213%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 110 Hospital Drive, Jefferson City, TN 37760
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals