CMS Price Transparency Data

Total knee replacement

Facility: Mercyone Dubuque Medical Center

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27447
  • Insurance Median: $5,764
  • Cash Discount Price: $39,409
  • vs. Medicare Baseline: 0.44x Medicare
The contracted insurance negotiated median rate for a Total knee replacement at Mercyone Dubuque Medical Center is $5,764. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $39,409. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.44x the Medicare baseline. Located in 250 Mercy Drive, Dubuque, IA.
Cash / Self-Pay
$39,409

Average discount available for prompt cash payment at this facility.

Insurance Median
$5,764

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: $39,409 (300%)
Insurance Median: $5,764 (44%)
Cash: $39,409 (300% of Medicare)
Ins. Median: $5,764 (44% 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 $11,518 88%
Medicaid / KanCare $11,631 - $11,676 89%
Aetna $12,507 95%
Medicare (plans) $12,507 - $13,018 95%
Blue Cross Blue Shield $12,632 96%
UnitedHealthcare $12,758 97%
Amish Hospital Aid $16,974 129%
Oscar $17,411 133%
Centivo $19,986 152%
Ambetter / Centene $21,441 163%
Claimdoc $25,653 196%
Nova $25,653 196%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 250 Mercy Drive, Dubuque, IA 52001
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals