CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Freestone Medical Center

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 470
  • Insurance Median: $12,725
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.91x Medicare
The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at Freestone Medical Center is $12,725. 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 0.91x the Medicare baseline. Located in 125 Newman St, Fairfield, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$12,725

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: $12,725 (91%)
Ins. Median: $12,725 (91% 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
Mcaid $7,697 55%
Misc Mcaid Hmo $7,697 55%
Superior Health Chip $7,697 55%
Tx Childrens Mcaid $7,697 55%
UnitedHealthcare $7,697 - $17,454 55%
Scott & White Commercial $11,535 82%
Scott & White Employees $11,535 82%
Aarp Mcare /Wellmed $12,725 91%
Aetna $12,725 91%
Allwell Superior Hlth $12,725 91%
Ambetter / Centene $12,725 91%
Care Improvement Plus $12,725 91%
Champva $12,725 91%
Humana $12,725 91%
Medicare (plans) $12,725 91%
Misc Mcare Replacement $12,725 91%
Pphp Prov Part Hlth Plan $12,725 91%
Scott & White Senior Care $12,725 91%
Superior Hlth Mcare Repl $12,725 91%
Tricare $12,725 91%
Triwest $12,725 91%
Triwest Va Ccn Claims $12,725 91%
Utmb Corr Mgd Care $12,725 91%
Va Vha Office Comm Care $12,725 91%
Veteran'S Administration $12,725 91%
Wellmed $12,725 91%
Workers Compensation $12,725 91%
Aarp $17,454 124%
Apwu $17,454 124%
Fringe Benefits $17,454 124%
Geha $17,454 124%
Uhcss $17,454 124%
Blue Cross Blue Shield $18,370 - $20,998 131%
Cigna $22,994 164%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 125 Newman St, Fairfield, TX 75840
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals