CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Medical City Weatherford

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 470
Insurance Median: $17,962
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.28x Medicare

The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at Medical City Weatherford is $17,962. 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 1.28x the Medicare baseline. Located in 713 E Anderson St, Weatherford, TX.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$17,962

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: $17,962 (128%)

Ins. Median: $17,962 (128% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Aetna	$2,313 - $7,819	16%
United	$4,151 - $55,235	30%
Multiplan Phcs	$11,348	81%
Blue Cross Blue Shield	$16,764 - $62,919	119%
Humana	$16,764 - $56,866	119%
Wellmed	$17,055	121%
Amerigroup	$17,106	122%
Integranet	$17,106	122%
Triwest Veterans	$17,106	122%
Wellcare	$17,106	122%
Care N Care	$17,277	123%
Cigna	$17,448 - $79,937	124%
Devoted Health	$17,448	124%
Mutual Of Omaha	$17,448	124%
Provider Partners Health Plan	$17,448	124%
Texas Independent Health Plan	$17,448	124%
American Health Plan Of Texas, Inc.	$17,962	128%
Procare Advantge	$17,962	128%
Superior Health Plan	$17,962	128%
Imperial Insurance Company	$18,133	129%
Verda Health Plan	$20,528	146%
Oscar	$21,955	156%
Molina	$27,199	194%
Evry Health	$27,246	194%
Superior	$30,620 - $38,318	218%
Molina Healthcare	$33,609	239%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $X.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify MS-DRG Code matches exactly: 470.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Medical City Weatherford is fully in-network.
Ask your insurer if "Prior Authorization" is required for MS-DRG code 470.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.