CMS Price Transparency Data

Total knee replacement

Facility: Sarasota Memorial Hospital

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $1,608
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.12x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at Sarasota Memorial Hospital is $1,608. 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 $13,116.76, this hospital’s rate is 0.12x the Medicare baseline. Located in 1700 S Tamiami Trl, Sarasota, FL.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,608

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%)

Insurance Median: $1,608 (12%)

Ins. Median: $1,608 (12% 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
Simply Healthcare Oncology	$167 - $1,564	1%
Sunshine State Oncology	$167 - $1,564	1%
Molina Oncology	$172 - $1,608	1%
Amerihealth Caritas Oncology	$175 - $1,638	1%
Community Care Plan Oncology	$175 - $1,638	1%
Blue Cross Blue Shield	$203 - $12,915	2%
Florida Community Care Oncology	$210 - $2,417	2%
UnitedHealthcare	$215 - $15,843	2%
Wellcare Oncology	$223 - $2,093	2%
Simply Freedom Optimum Oncology	$226 - $2,117	2%
Aetna	$241 - $22,214	2%
Oscar Oncology	$352 - $3,303	3%
Ambetter / Centene	$3,496 - $34,872	27%
Simply Healthcare	$5,958 - $6,256	45%
Sunshine State	$6,256	48%
Careworks	$6,348 - $22,214	48%
Enlyte	$6,348 - $22,214	48%
Molina	$6,435	49%
Amerihealth Caritas	$6,554	50%
Community Care Plan	$6,554	50%
Florida Community Care	$6,554 - $14,207	50%
Oscar Health	$6,934	53%
Simply Freedom Optimum	$13,561	103%
Wellcare	$13,561	103%

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 $X.
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 Sarasota Memorial Hospital 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.