CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Medical Center of McKinney

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 470
  • Insurance Median: $16,954
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.21x Medicare
The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at Medical Center of McKinney is $16,954. 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 1.21x the Medicare baseline. Located in 4500 Medical Center Drive, McKinney, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$16,954

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: $16,954 (121%)
Ins. Median: $16,954 (121% 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
Aetna $2,433 - $15,937 17%
City Of Mckinney $2,800 20%
United $4,151 - $55,235 30%
Healthcare Highways $6,200 - $60,000 44%
Multiplan Phcs $12,029 86%
Humana $15,824 - $56,866 113%
Wellmed $16,098 115%
Amerigroup $16,147 115%
Blue Cross Blue Shield $16,147 - $68,278 115%
Integranet $16,147 115%
Triwest Veterans $16,147 115%
Care N Care $16,308 116%
Cigna $16,470 - $88,635 117%
Devoted Health $16,470 117%
Provider Partners Health Plan $16,470 117%
Texas Independent Health Plan $16,470 117%
Wellcare $16,470 117%
Mutual Of Omaha $16,793 120%
American Health Plan Of Texas, Inc. $16,954 121%
Procare Advantge $16,954 121%
Superior Health Plan $16,954 121%
Imperial Insurance Company $17,116 122%
Universal Healthcare Group $17,439 124%
Molina $17,600 125%
Bravo Health $17,923 128%
Fidelis Securecare $18,246 130%
Verda Health Plan $19,376 138%
Usa Managed Care $21,936 156%
Oscar $21,955 156%
Corvel Corporation $22,859 163%
Curative Administrators $26,326 187%
Evry Health $27,246 194%
Superior $28,903 - $36,169 206%
Molina Healthcare $33,885 241%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4500 Medical Center Drive, McKinney, TX 75069
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals