CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: St Luke's Hospital at the Vintage

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 470
Insurance Median: $17,282
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.23x Medicare

The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at St Luke's Hospital at the Vintage is $17,282. 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 1.23x the Medicare baseline. Located in 20171 Chasewood Park Drive, Houston, TX.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$17,282

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: $17,282 (123%)

Ins. Median: $17,282 (123% 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	$3,846 - $24,195	27%
Kelseycare	$4,590 - $21,210	33%
Renaissance	$11,312	81%
United	$13,323 - $21,855	95%
Kelsey	$15,200	108%
Healthsmart	$15,273	109%
Blue Cross Blue Shield	$15,711	112%
Cigna	$15,711 - $44,405	112%
Humana	$15,711 - $19,986	112%
Selectcare	$15,711	112%
UnitedHealthcare	$16,025	114%
Amerivantage	$16,182	115%
Devoted	$16,811	120%
Scanhealth	$16,811	120%
Kindred	$17,282	123%
Bright Health	$21,691	154%
Employer Direct	$21,996	157%
Community Health Choice	$23,567	168%
Superior Health Plan	$23,567	168%
Wellpoint	$23,567	168%
Independent Med System	$23,680	169%
PHCS	$34,840	248%
PHCS Savility	$34,840	248%
Nx Health	$51,061	364%

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 St Luke's Hospital at the Vintage 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.