CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Multicare Valley Hospital

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 470
  • Insurance Median: $26,234
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.87x Medicare
The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at Multicare Valley Hospital is $26,234. 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 1.87x the Medicare baseline. Located in 12606 East Mission Avenue, Spokane Valley, WA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$26,234

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: $26,234 (187%)
Ins. Median: $26,234 (187% 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
Blue Cross Blue Shield $15,926 113%
Community Health Plan Of Washington $15,926 - $26,852 113%
Molina $15,926 - $29,464 113%
Aetna $16,404 - $34,646 117%
Regence $16,404 117%
UnitedHealthcare $16,564 - $39,420 118%
Wellcare $16,723 119%
First Choice $18,456 - $33,554 131%
Pacificsource $19,595 - $25,615 140%
Premera $24,852 - $35,125 177%
Ambetter / Centene $27,100 193%
Cigna $30,711 219%
Regence/Asuris $34,332 244%
Kaiser $39,556 282%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12606 East Mission Avenue, Spokane Valley, WA 99216
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals