CMS Price Transparency Data

Total knee replacement

Facility: Waverly Health Center

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $2,534
Cash Discount Price: $3,208
vs. Medicare Baseline: 0.19x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at Waverly Health Center is $2,534. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,208. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.19x the Medicare baseline. Located in 312 9Th Street Sw, Waverly, IA.

Cash / Self-Pay

$3,208

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,534

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: $3,208 (24%)

Insurance Median: $2,534 (19%)

Cash: $3,208 (24% of Medicare)

Ins. Median: $2,534 (19% 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
UnitedHealthcare	$941 - $4,324	7%
Choicecare Network - All Plans	$1,046	8%
Health Alliance-All Plans	$1,046	8%
Midlands Choice Mcare	$1,046	8%
Medicare (plans)	$1,171	9%
Wellmark Hmo	$2,426	18%
Midlands Choice-All Other Plans	$2,641	20%
Wellmark Ppo - All Other Plans	$2,854	22%
Hlth Partners Bridges Ntwrk	$4,287	33%
Hlth Partners Open Ntwrk - All Other Plans	$4,287	33%
Aetna	$5,244	40%

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 $3,208.
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 Waverly Health Center 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.