CMS Price Transparency Data

Total knee replacement

Facility: Northside Hospital Duluth

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27447
  • Insurance Median: $11,990
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.91x Medicare
The contracted insurance negotiated median rate for a Total knee replacement at Northside Hospital Duluth is $11,990. 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 0.91x the Medicare baseline. Located in 3620 Howell Ferry Road, Duluth, GA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$11,990

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: $11,990 (91%)
Ins. Median: $11,990 (91% 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
Us Dept Of Labor Wc $2,186 17%
Kaiser $2,232 - $13,034 17%
One Call Diagnostics $3,232 25%
Mti $4,040 31%
Homelink $4,293 33%
Ambetter / Centene $6,316 - $10,726 48%
Amerigroup $6,316 - $8,978 48%
Institutional Gwinnett County Govt $6,316 - $8,978 48%
Medicaid / KanCare $6,316 - $10,325 48%
Caresource $6,505 - $18,600 50%
Cigna $7,594 - $11,990 58%
Aetna $9,008 - $12,781 69%
Blue Cross Blue Shield $9,365 - $34,850 71%
Oscar $10,915 83%
Health One Alliance_Ppo $12,000 91%
Northside Health Network $12,052 92%
Clear Springs Eon Health $12,655 96%
Medicare (plans) $12,655 - $15,186 96%
UnitedHealthcare $12,655 - $19,882 96%
Va Ccn $12,655 96%
Humana $12,781 - $13,161 97%
Bccp $12,878 98%
Cbww $12,878 98%
Truths Community $12,878 98%
Coventry $12,908 - $30,000 98%
Wellcare $13,034 99%
Clover Health $13,286 101%
Pruitt Health Premier $13,287 101%
Fairly Group $14,548 111%
Genex/Priority Care Solutions $14,671 112%
Spreemo $14,671 112%
Authentic 4D $16,505 126%
Streamline Imaging $16,505 126%
Corvel Workers Comp $18,339 140%
Employers Choice Network $18,339 140%
Fieldale Farms Wc $18,339 140%
Georgia Workers Compensation $18,339 140%
Lantern $20,286 155%
Bridgehealth $22,386 171%
Quick Trip $27,500 210%
Novanet_Ppo $35,000 267%
Phcs $37,500 286%
Champus Va $50,000 381%
Johnson Ferry Imaging $50,000 381%
Marietta Dermatology Clinical Research Inc $50,000 381%
Tricare $50,000 381%
West Paces Imaging Agreement $50,000 381%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3620 Howell Ferry Road, Duluth, GA 30096
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals