Hip or knee replacement (inpatient stay)
Facility: Physicians Regional Medical Center
Billing Code: 470 (MS-DRG)
- CPT Billing Code: 470
- Insurance Median: $13,846
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.99x 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 |
|---|---|---|
| Medicaid / KanCare | $1,459 | 10% |
| UnitedHealthcare | $1,459 - $15,250 | 10% |
| Novanet Work Comp Tn | $2,324 | 17% |
| Occunet Work Comp Tn | $2,347 | 17% |
| Tn Work Comp | $2,347 | 17% |
| Self Pay | $6,006 - $6,252 | 43% |
| Amerigroup | $7,422 - $14,114 | 53% |
| Amerigroup Community Care | $7,422 | 53% |
| Blue Cross Blue Shield | $7,899 - $35,463 | 56% |
| Node Bluecare Plus Tn Mcr Adv | $12,283 - $12,499 | 87% |
| Humana | $13,412 - $13,444 | 95% |
| Medicare (plans) | $13,444 - $14,164 | 96% |
| Node Farm Bureau Mcr Adv | $13,679 | 97% |
| Aetna | $13,846 - $18,446 | 99% |
| Node Healthspring Mcr Adv | $13,846 | 99% |
| Wellcare | $14,196 | 101% |
| Node Va | $14,417 - $14,706 | 103% |
| Node Devoted Health Mcr Adv | $14,446 | 103% |
| Node Nhc Mcr Adv | $14,785 | 105% |
| Multiplan | $14,905 - $19,597 | 106% |
| Node Us Dept Of Labor | $20,899 | 149% |
| Us Department Of Labor | $20,899 | 149% |
| Node Point Comfort Underwriters | $25,313 - $26,672 | 180% |
| Ambetter / Centene | $26,672 | 190% |