CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: HCA Houston Healthcare Conroe

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 470
  • Insurance Median: $18,647
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.33x Medicare
The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at HCA Houston Healthcare Conroe is $18,647. 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 1.33x the Medicare baseline. Located in 504 Medical Center Blvd, Conroe, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$18,647

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: $18,647 (133%)
Ins. Median: $18,647 (133% 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
Coventry National First Health $1,941 - $19,024 14%
United $2,591 - $33,000 18%
Aetna $13,211 - $27,933 94%
Blue Cross Blue Shield $15,411 - $41,790 110%
Cigna $16,562 - $47,378 118%
Humana $17,211 - $28,297 123%
Averde Health $17,360 124%
Oscar $17,407 - $22,549 124%
Wellmed $17,616 125%
Amerigroup $17,762 126%
Geo Group - Joe Corley Detention Facility $17,762 126%
Integranet Amerigroup Ipa $17,762 126%
Kelsey Seybold $17,762 126%
Texas Healthcare Foundation $17,762 126%
Triwest Healthcare Alliance $17,762 126%
Texas Independent Health Plan $17,940 128%
Van Lang Ipa $17,940 128%
Wellcare $17,940 128%
Devoted Health $18,117 129%
Provider Partners Health Plan Of Texas $18,117 129%
American Health Plan $18,650 133%
Procare Advantage $18,650 133%
Superior Health Plan $18,650 133%
Imagine Health $19,137 136%
Molina $19,361 138%
Fidelis Securecare Of Tx $20,782 148%
Shared Health $21,314 152%
Verda Health Plan $21,314 152%
Universal Healthcare Group $22,735 162%
Healthcare Highways $23,469 167%
Corvel Corporation $25,146 179%
Community Health Choice $25,755 183%
Curative Administrators $26,326 187%
Omni Healthcare $26,670 190%
Evry Health $26,964 192%
Superior $27,531 196%
Molina Healthcare $28,868 206%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 504 Medical Center Blvd, Conroe, TX 77304
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals