CMS Price Transparency Data

Total knee replacement

Facility: HCA Florida North Florida Hospital

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $18,340
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.40x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at HCA Florida North Florida Hospital is $18,340. 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 1.40x the Medicare baseline. Located in 6500 W Newberry Rd, Gainesville, FL.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$18,340

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: $18,340 (140%)

Ins. Median: $18,340 (140% 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
Molina Healthcare	$1,950 - $3,242	15%
Simply	$2,250	17%
Corvel Corporation	$6,180 - $21,627	47%
Prime Health	$6,310 - $22,083	48%
Careworks (Rockport Community)	$6,506 - $22,766	50%
Avmed	$7,042 - $41,380	54%
Florida Complete Care	$10,600	81%
Clear Spring Health	$11,000	84%
Humana	$11,000 - $34,002	84%
Align Senior Care	$12,000	91%
Ultimate Health Plan	$12,500	95%
Blue Cross Blue Shield	$13,437 - $27,429	102%
Cigna	$14,857 - $35,535	113%
Gold Kidney Of Florida	$16,089	123%
American Health Plan	$17,429	133%
Aetna	$22,627 - $29,564	173%
Oscar	$28,164	215%
Simply Healthcare	$28,852	220%
Evolutions	$29,925	228%
United	$45,365	346%

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 HCA Florida North Florida 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.