CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Multicare Good Samaritan Hospital

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 470
Insurance Median: $35,161
Cash Discount Price: Unavailable
vs. Medicare Baseline: 2.50x Medicare

The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at Multicare Good Samaritan Hospital is $35,161. 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 2.50x the Medicare baseline. Located in 401 15Th Avenue Se, Puyallup, WA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$35,161

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: $35,161 (250%)

Ins. Median: $35,161 (250% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 250% of the Medicare baseline (a markup of 150%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Regence	$16,872 - $42,869	120%
Aetna	$17,206 - $48,118	123%
UnitedHealthcare	$17,373 - $44,192	124%
Molina	$17,540 - $30,903	125%
Wellcare	$17,540	125%
Community Health Plan Of Washington	$18,375 - $28,164	131%
Pacificsource	$23,536 - $34,311	168%
First Choice	$26,273 - $47,771	187%
Premera	$29,112 - $43,751	207%
Ambetter / Centene	$30,877	220%
Cigna	$33,939	242%
Uniform Medical	$39,121	279%
Kaiser	$39,556	282%

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 Multicare Good Samaritan Hospital 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.