CMS Price Transparency Data

Total knee replacement

Facility: Baptist Medical Center Beaches

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $7,150
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.55x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at Baptist Medical Center Beaches is $7,150. 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 0.55x the Medicare baseline. Located in 1350 13Th Ave S, Jacksonville Beach, FL.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$7,150

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: $7,150 (55%)

Ins. Median: $7,150 (55% 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
Amerigroup Of Georgia	$5,958	45%
Daniel Memorial	$5,958	45%
Corvel	$6,035	46%
Simply Healthcare Plans	$6,256 - $7,150	48%
Simply Healthcare Plans - Cha	$6,256	48%
Amerihealth Caritas	$6,554	50%
Florida Community Care	$6,554 - $13,561	50%
Sunshine State Health Plan	$6,554	50%
United Community Plan	$6,554	50%
Vivida Health	$6,554	50%
Molina Healthcare Of Florida	$7,090	54%
Aetna	$7,150 - $13,174	55%
Community Hospice Of Northeast Florida	$12,915	98%
Pace	$12,915	98%
Tomorrow'S Rainbow	$12,915	98%
Va Ccn	$12,915	98%
UnitedHealthcare	$13,045	99%
Devoted	$13,690	104%
Upmc	$14,207	108%
Ambetter / Centene	$30,997	236%

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 Baptist Medical Center Beaches 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.