CMS Price Transparency Data

Total knee replacement

Facility: Medical Center Enterprise

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27447
  • Insurance Median: $11,245
  • Cash Discount Price: $16,067
  • vs. Medicare Baseline: 0.86x Medicare
The contracted insurance negotiated median rate for a Total knee replacement at Medical Center Enterprise is $11,245. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $16,067. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.86x the Medicare baseline. Located in 400 N Edwards Street, Enterprise, AL.
Cash / Self-Pay
$16,067

Average discount available for prompt cash payment at this facility.

Insurance Median
$11,245

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$13,116.76

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $13,116.76 (100%)
Cash / Self-Pay: $16,067 (122%)
Insurance Median: $11,245 (86%)
Cash: $16,067 (122% of Medicare)
Ins. Median: $11,245 (86% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $13,116.76 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
Medicaid / KanCare $511 - $5,905 4%
Veterans Eval Services $1,138 9%
UnitedHealthcare $7,465 - $11,185 57%
Blue Cross Blue Shield $10,878 - $12,310 83%
Humana $10,878 83%
Medicare (plans) $10,878 83%
Select Health $10,987 84%
Covenant Hospice $11,065 84%
Dayspring Hospice $11,065 84%
Node Hospice Non Par $11,065 84%
Node Va $11,065 84%
Southerncare Hospice $11,065 84%
Healthspring $11,096 85%
Node Devoted Health Mcr Adv $11,096 85%
Node Clover Mcr Adv $11,176 85%
Aetna $11,204 - $124,967 85%
Node Wellcare Mcr Adv $11,286 86%
Eon Health $11,422 87%
Wiregrass Hospice $11,743 90%
Node Us Dept Of Labor $13,831 105%
Self Pay $16,067 122%
Ambetter / Centene $16,598 127%
Cigna $18,421 - $117,326 140%
Occunet $19,364 148%
American Employee Alliance $71,410 544%
Alamed $107,115 817%
City Of Enterprise $107,115 817%
Affordable Health $124,967 953%
Health Choice $124,967 953%
Novanet Ppo $124,967 953%
Coventry Work Comp Al $131,394 1002%
Multiplan $132,108 - $137,464 1007%
Wc Dept Ind Relations $142,820 1089%
Corvel $151,746 1157%
Galaxy Health $160,672 1225%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 400 N Edwards Street, Enterprise, AL 36330
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals