Hip or knee replacement (inpatient stay)
Facility: Select Specialty Hospital - Wichita
Billing Code: 470 (MS-DRG)
- CPT Billing Code: 470
- Insurance Median: $1,700
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.12x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
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 | $1,615 - $1,880 | 11% |
| Cigna | $1,682 | 12% |
| Phcs-Multiplan | $1,700 | 12% |
| UnitedHealthcare | $1,836 | 13% |
| Healthcare Highways | $1,957 | 14% |
| Sidecare Health Insurance Solutions | $2,000 | 14% |
| Wppa | $2,308 | 16% |
Consumer Guidance & Cost Commentary
For a hip or knee replacement at Select Specialty Hospital - Wichita in Wichita, KS, the negotiated rates for in-network payers range from $1,615 to $2,308, with a median negotiated amount of $1,700. While commercial insurance contracts cap these costs, it is important to note that cash prices are often lower than the rates charged to insured members. Patients with high-deductible plans may find that paying out-of-pocket directly is more cost-effective if the insurance negotiated rate exceeds the cash price, though specific cash rates are not available for this procedure. To secure the lowest possible cost, patients should contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can significantly reduce the final bill by bypassing administrative fees associated with insurance claims processing.
This procedure is billed under MS-DRG code 470, and the facility's pricing is benchmarked against the Medicare rate of $14,044.15. Commercial negotiated rates typically average between 200% and 300% of the Medicare amount, reflecting the administrative overhead and contract dynamics of the insurance system. Since the data does not provide specific state or county average comparisons for this specific code, patients should rely on the Medicare benchmark as the objective baseline for evaluating fair pricing. If a patient receives a bill that exceeds the negotiated rate or includes unexpected charges, they should request a formal itemized audit to identify errors such as code unbundling or services not rendered, as over 80% of hospital bills contain discrepancies that can be corrected through written dispute.