CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Baylor Scott & White Medical Center - Centennial

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 470
  • Insurance Median: $17,558
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.25x Medicare
The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at Baylor Scott & White Medical Center - Centennial is $17,558. 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 1.25x the Medicare baseline. Located in 12505 Lebanon Road, Frisco, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$17,558

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: $17,558 (125%)
Ins. Median: $17,558 (125% 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
Baylor Scott & White Health Plan $13,588 - $25,746 97%
Humana $14,304 - $34,953 102%
Triwest $14,304 102%
Wellpoint (Fka Amerigroup) $14,733 105%
Corvel $14,984 107%
Prime Health Services $14,984 107%
American Health Plan $15,019 107%
Blue Cross Blue Shield $15,019 - $27,279 107%
Healthspring $15,019 107%
Molina $15,019 107%
Procare Advantage $15,019 107%
Superior Health Plan $15,019 107%
University Of Mary Hardin-Baylor $16,225 116%
UnitedHealthcare $16,449 - $42,989 117%
Cigna $23,356 - $27,477 166%
Employers Health Network $25,749 183%
Ambetter / Centene $32,326 230%
Healthsmart $34,290 - $36,028 244%
Aetna $34,763 248%
Private Health Care System $35,742 254%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12505 Lebanon Road, Frisco, TX 75035
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals