CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Medical City Lewisville

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 470
Insurance Median: $18,150
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.29x Medicare

The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at Medical City Lewisville is $18,150. 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 1.29x the Medicare baseline. Located in 500 West Main Street, Lewisville, TX.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$18,150

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: $18,150 (129%)

Ins. Median: $18,150 (129% 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	$2,433 - $17,061	17%
United	$4,100 - $55,235	29%
Healthcare Highways	$6,200 - $60,000	44%
Multiplan Phcs	$11,348	81%
Humana	$16,940 - $56,866	121%
Wellmed	$17,234	123%
Amerigroup	$17,285	123%
Blue Cross Blue Shield	$17,285 - $62,442	123%
Integranet	$17,285	123%
Triwest Health Alliance	$17,285	123%
Care N Care	$17,458	124%
Wellcare	$17,458	124%
Cigna	$17,631 - $79,937	126%
Devoted Health	$17,631	126%
Provider Partners Health Plan	$17,631	126%
Texas Independent Health Plan	$17,631	126%
Mutual Of Omaha	$17,804	127%
American Health Plan Of Texas, Inc.	$18,150	129%
Procare Advantge	$18,150	129%
Superior Health Plan	$18,150	129%
Imperial Insurance Company	$18,322	130%
Universal Healthcare Group	$18,668	133%
Molina	$18,841	134%
Bravo Health	$19,187	137%
Fidelis Securecare	$19,532	139%
Verda Health Plan	$20,742	148%
Oscar	$21,955	156%
Usa Managed Care	$23,482	167%
Corvel Corporation	$24,471	174%
Curative Administrators	$26,326	187%
Evry Health	$27,246	194%
Superior	$30,941 - $38,719	220%
Molina Healthcare	$34,363	245%

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 Lewisville 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.