CMS Price Transparency Data
Hip or knee replacement (inpatient stay)
Facility: Clovis Community Medical Center
Billing Code: 470 (MS-DRG)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 470
- Insurance Median: $18,916
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.35x Medicare
The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at Clovis Community Medical Center is $18,916. 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 1.35x the Medicare baseline. Located in 2755 Herndon Ave, Clovis, CA.
Cash / Self-Pay
Unavailable
Average discount available for prompt cash payment at this facility.
Insurance Median
$18,916
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: $18,916 (135%)
Ins. Median: $18,916 (135% 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.
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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 | $6,777 - $23,439 | 48% |
| Blue Shield | $10,391 - $18,916 | 74% |
| Humana | $11,946 - $18,916 | 85% |
| UnitedHealthcare | $12,070 - $19,199 | 86% |
| Healthsmart | $12,264 | 87% |
| Healthnet | $12,916 | 92% |
| Cigna | $14,195 - $18,916 | 101% |
| Network By Design | $14,482 | 103% |
| Railroad Part A | $18,916 | 135% |
| Generic | $18,916 | 135% |
| Sante-Healthnet Seniority | $18,916 | 135% |
| Healthnet Sante - Sub Cap Dual Risk | $18,916 | 135% |
| Todays Pyramid | $18,916 | 135% |
| Sante-Sub Cap Ma Brand New Day | $18,916 | 135% |
| Scan Health Plan | $18,916 | 135% |
| Brand New Day | $18,916 | 135% |
| Railroad Part A & B | $18,916 | 135% |
| Medi-Cal Innovative Integrated Health | $18,916 | 135% |
| Healthnet HMO - La Salle | $18,916 | 135% |
| Bscphp HMO - First Choice | $18,916 | 135% |
| Blue Cross Blue Shield | $18,916 | 135% |
| Blue Shield Promise - Imperial | $18,916 | 135% |
| Generic Victims of Crime | $18,916 | 135% |
| Healthnet HMO - Sante | $18,916 | 135% |
| Blue Shield Hmo-Cvmp/Medpro | $18,916 | 135% |
| Healthnet Sante Dual Risk | $18,916 | 135% |
| Victims of Crime | $18,916 | 135% |
| Healthnet HMO - Cvmp/Medpro | $18,916 | 135% |
| Cares Act Provider Relief Fund | $18,916 | 135% |
| Bscphp - Dhmso | $18,916 | 135% |
| Sante-Blue Shield/Sante | $18,916 | 135% |
| Us Marshal | $18,916 | 135% |
| Care1St HMO - Ehs | $18,916 | 135% |
| Medicare (plans) | $18,916 | 135% |
| Meritage Brand New Day | $18,916 | 135% |
| Meritage Healthnet HMO | $18,916 | 135% |
| Blue Shield Sante | $18,916 | 135% |
| Blue Shield 65 Plus HMO Ehs | $18,916 | 135% |
| Sequoia Pace - Peak Tpa | $18,916 | 135% |
| Sante Sub Cap-Blue Shield/Sante | $18,916 | 135% |
| Wellcare | $18,916 | 135% |
| Healthnet HMO - Dhmso | $18,916 | 135% |
| Generic Bscphp | $18,916 | 135% |
| Gemcare HMO | $18,916 | 135% |
| Bscphp - First Choice | $18,916 | 135% |
| Blue Shield Saint Agnes | $18,916 | 135% |
| Railroad Part B | $18,916 | 135% |
| Hartford Life Supplement | $18,916 | 135% |
| Meritage Blue Shield 65 Plus | $18,916 | 135% |
| Sante Sub Cap Healthnet Seniority | $18,916 | 135% |
| Blue Shield 65 Plus HMO First Choice | $18,916 | 135% |
| Healthnet Sante | $18,916 | 135% |
| Advantek Table Mountain Rancheria Tribal Member | $18,916 | 135% |
| Innovative Integrated Health Community Plans HMO | $20,807 | 148% |
| Champion Health Plan of California Ma | $20,807 | 148% |
| Alignment Health Plan | $20,807 | 148% |
| Imperial Health Plan HMO | $21,753 | 155% |
| Kaiser | $22,323 | 159% |
| Correctcare Integrated Health | $24,590 | 175% |
| Coalinga State Hospital | $37,831 | 269% |
| Naphcare Inc-Mendota | $40,669 | 290% |