CMS Price Transparency Data

Total knee replacement

Facility: University of Iowa Hospital & Clinics

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $7,762
Cash Discount Price: $7,011
vs. Medicare Baseline: 0.59x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at University of Iowa Hospital & Clinics is $7,762. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,011. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.59x the Medicare baseline. Located in 200 Hawkins Drive, Iowa City, IA.

Cash / Self-Pay

$7,011

Average discount available for prompt cash payment at this facility.

Insurance Median

$7,762

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: $7,011 (53%)

Insurance Median: $7,762 (59%)

Cash: $7,011 (53% of Medicare)

Ins. Median: $7,762 (59% 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
Aetna	$1,145 - $41,420	9%
Iowa Total Care	$1,145 - $12,591	9%
Medical Associates	$1,145 - $6,543	9%
Molina Healthcare	$1,145	9%
UnitedHealthcare	$1,145 - $17,281	9%
Blue Cross Blue Shield	$1,168 - $12,349	9%
Healthpartners	$1,168 - $12,349	9%
American Health Plan	$1,202 - $12,713	9%
Wellpoint (Amerigroup)	$1,202 - $12,713	9%
Immergrun	$2,504	19%
Aplos Health Plan	$2,920	22%
Quad City Community Healthcare	$4,151 - $7,512	32%
Midlands Choice	$4,349 - $5,116	33%
Oscar Health	$6,310	48%
Great River Health Systems	$7,011	53%
Sedgwick	$8,013	61%
Global Excel	$8,514	65%
Sanford Health Plan	$8,514	65%
Employee Benefit Systems	$8,814	67%
Sisco	$8,814	67%
Healthsmart	$9,014	69%
Hfn	$9,215	70%
Multiplan	$9,215	70%

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 $7,011.
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 University of Iowa Hospital & Clinics 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.