CMS Price Transparency Data

Total knee replacement

Facility: Stanford Health Care

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $1,938
Cash Discount Price: $4,536
vs. Medicare Baseline: 0.15x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at Stanford Health Care is $1,938. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,536. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.15x the Medicare baseline. Located in 300 Pasteur Drive, Stanford, CA.

Cash / Self-Pay

$4,536

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,938

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: $4,536 (35%)

Insurance Median: $1,938 (15%)

Cash: $4,536 (35% of Medicare)

Ins. Median: $1,938 (15% 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.

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
Cigna	$215 - $2,375	2%
Beech St [10600]	$258 - $2,423	2%
Claritev [13400]	$258 - $2,423	2%
Kaiser Northern Ca [12900]	$258 - $2,423	2%
Private Healthcare Systems (Phcs) [14200]	$258 - $2,423	2%
Health Plan Of San Mateo [31200]	$261 - $1,955	2%
Healthnet Alt Payer [912100000]	$363 - $2,177	3%
Healthnet [12100]	$363 - $2,177	3%
Blue Card (Out Of State) [40000]	$396 - $3,709	3%
Blue Cross Blue Shield	$396 - $45,398	3%
Shca Comm Intel [20300000]	$396 - $3,709	3%
UnitedHealthcare	$427 - $48,543	3%
Aetna	$489 - $52,916	4%
American Specialty Health Plan Alt Payer [971000000]	$570 - $4,279	4%
Blue Card (Out Of State) - Blue Shield [40200]	$570 - $4,279	4%
Blue Shield Alt Payer [970000000]	$570 - $4,279	4%
Blue Shield [70000]	$570 - $4,279	4%
Psych Blue Shield Alt Payer [970000100]	$570 - $4,279	4%
Healthnet	$18,884	144%
Blue Shield	$39,140	298%

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 $4,536.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 27447.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Stanford Health Care is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 27447.
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.