Hip or knee replacement (inpatient stay)
Facility: Knapp Medical Center
Billing Code: 470 (MS-DRG)
- CPT Billing Code: 470
- Insurance Median: $18,758
- Cash Discount Price: $19,239
- vs. Medicare Baseline: 1.34x 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 |
|---|---|---|
| Corvel | $13,467 | 96% |
| Zelis Healthcare Fka Stratose | $14,429 | 103% |
| Provider Network Of America | $15,391 | 110% |
| Provider Select | $16,834 | 120% |
| Blue Cross Blue Shield | $17,261 - $20,255 | 123% |
| Three Rivers | $17,315 | 123% |
| Cigna | $17,362 - $17,883 | 124% |
| Superior Health Plan | $17,362 - $25,011 | 124% |
| Texas Bluebonnet Health Plan | $17,362 - $31,745 | 124% |
| UnitedHealthcare | $17,362 | 124% |
| Wellmed Aarp Ma Fka Physicians Health Choice | $17,362 | 124% |
| Molina | $18,230 - $29,821 | 130% |
| Multiplan | $18,230 | 130% |
| Provider Partners Health Plan | $18,230 | 130% |
| Imperial Insurance Companies | $18,404 | 131% |
| Americas Choice Provider Network (Acpn) | $18,662 | 133% |
| Division Of Immigration Health | $18,854 | 134% |
| Corporate Remedies (Wc) | $19,239 | 137% |
| Coventry (First Health) | $19,239 | 137% |
| Medicare (plans) | $19,239 | 137% |
| Prime Health Services | $19,239 | 137% |
| Worker Comp | $19,239 | 137% |
| Tricare | $20,501 | 146% |
| Magic Valley Electric Cooperative | $22,570 | 161% |
| Employer Direct Healthcare | $25,011 | 178% |
| Frontier Health (Fka Asserta Health) | $25,011 | 178% |
| Naphcare | $26,911 | 192% |
| Occunet | $30,383 | 216% |
| National Healthcare Solutions, Inc. (Nhsi) And Independent Medical Solutions (Ims) | $30,783 | 219% |
| Baker Benefits Administrators | $33,669 | 240% |