CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Christus Mother Frances Hospital

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 470
  • Insurance Median: $11,750
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.84x Medicare
The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at Christus Mother Frances Hospital is $11,750. 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 0.84x the Medicare baseline. Located in 800 East Dawson, Tyler, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$11,750

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: $11,750 (84%)
Ins. Median: $11,750 (84% 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
Humana $3,408 - $11,750 24%
UnitedHealthcare $4,398 - $11,750 31%
Phcs $9,371 67%
Christus Health $11,162 - $16,450 79%
Aetna $11,750 84%
Allwell $11,750 84%
Blue Cross Blue Shield $11,750 - $19,028 84%
Cigna $11,750 - $31,205 84%
Triwest $11,750 84%
Washington National $11,750 84%
Wellcare $11,750 84%
Peoples Health $12,102 86%
Provider Partners Health Plan $12,102 86%
Shared Health Insurance Company $12,337 88%
Amerigroup $12,690 90%
Imperial Health Plan $12,925 92%
Medicare (plans) $12,925 92%
Procare Advantage $12,925 92%
Healthcare Highways $15,770 112%
Naphcare Inc. $27,025 192%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 800 East Dawson, Tyler, TX 75701
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals