CMS Price Transparency Data

Total knee replacement

Facility: Boundary Community Hospital

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $3,289
Cash Discount Price: $1,914
vs. Medicare Baseline: 0.25x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at Boundary Community Hospital is $3,289. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,914. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.25x the Medicare baseline. Located in 6640 Kaniksu Street, Bonners Ferry, ID.

Cash / Self-Pay

$1,914

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,289

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: $1,914 (15%)

Insurance Median: $3,289 (25%)

Cash: $1,914 (15% of Medicare)

Ins. Median: $3,289 (25% 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
Pacificsource Comm - All Other Plans	$530 - $16,592	4%
Molina Mcaid	$987 - $10,263	8%
Molina Comm/Mrketplce - All Other Plans	$1,058 - $13,117	8%
Molina Mcr Adv	$1,058 - $9,408	8%
UnitedHealthcare	$1,058 - $14,539	8%
Cigna	$1,770 - $16,250	13%
Bc Idaho Comm - All Other Plans	$2,036 - $16,763	16%
Bc Idaho Qhp	$2,214 - $16,079	17%
Regence Blue Shield - All Plans	$2,474 - $16,421	19%
Aetna	$3,289 - $11,118	25%

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 $1,914.
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 Boundary Community Hospital 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.