CMS Price Transparency Data

Total knee replacement

Facility: Mercyone North Iowa Medical Center

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27447
  • Insurance Median: $13,117
  • Cash Discount Price: $76,626
  • vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a Total knee replacement at Mercyone North Iowa Medical Center is $13,117. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $76,626. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 1.00x the Medicare baseline. Located in 1000 Fourth Street Sw, Mason City, IA.
Cash / Self-Pay
$76,626

Average discount available for prompt cash payment at this facility.

Insurance Median
$13,117

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: $76,626 (584%)
Insurance Median: $13,117 (100%)
Cash: $76,626 (584% of Medicare)
Ins. Median: $13,117 (100% 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
Iowa Total Care $12,423 95%
Medicaid / KanCare $12,544 - $12,593 96%
Bcn Domestic $13,117 100%
Blue Benefit Administrators Of Massachusetts $13,117 100%
Blue Care Network $13,117 100%
Blue Cross Blue Shield $13,117 - $13,697 100%
Blue Distinction Transplant $13,117 100%
Blue Shield - Ca $13,117 100%
Blue Shield - Id (Regence) $13,117 100%
Blue Shield - Ny Highmark Northeastern $13,117 100%
Blue Shield - Ny Highmark Western $13,117 100%
Blue Shield - Pa (Highmark) $13,117 100%
Blue Shield - Wa (Regence) $13,117 100%
Kaiser Domestic $13,117 100%
Pre-Employment $13,117 100%
Wc Domestic $13,117 100%
Aetna $13,561 103%
Medicare (plans) $13,561 - $14,115 103%
UnitedHealthcare $13,833 105%
Centivo $17,021 130%
Oscar $18,240 139%
Amish Hospital Aid $18,405 140%
Ambetter / Centene $23,248 177%
Claimdoc $27,815 212%
Nova $27,815 212%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Fourth Street Sw, Mason City, IA 50401
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals