CMS Price Transparency Data

Total knee replacement

Facility: Methodist Jennie Edmundson

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $5,333
Cash Discount Price: $2,286
vs. Medicare Baseline: 0.41x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at Methodist Jennie Edmundson is $5,333. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,286. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.41x the Medicare baseline. Located in 933 East Pierce Street, Council Bluffs, IA.

Cash / Self-Pay

$2,286

Average discount available for prompt cash payment at this facility.

Insurance Median

$5,333

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: $2,286 (17%)

Insurance Median: $5,333 (41%)

Cash: $2,286 (17% of Medicare)

Ins. Median: $5,333 (41% 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
Medicare (plans)	$1,040 - $13,169	8%
Elite Choice - Mje	$1,988 - $26,803	15%
Ambetter / Centene	$2,166 - $27,197	17%
Blue Cross Blue Shield	$2,643 - $19,121	20%
Midlands Choice	$2,895 - $5,333	22%
Aetna	$3,028 - $12,911	23%
Medica	$3,238 - $16,112	25%
Ne Furniture Mart	$3,505 - $4,571	27%
Medica Choice	$3,810 - $18,955	29%
UnitedHealthcare	$4,571 - $16,122	35%
Humana	$12,911	98%
Wellmark	$22,373 - $24,610	171%

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 $2,286.
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 Methodist Jennie Edmundson 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.