CMS Price Transparency Data

Total knee replacement

Facility: Saint Francis Hospital-Evanston

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27447
  • Insurance Median: $13,691
  • Cash Discount Price: $13,690
  • vs. Medicare Baseline: 1.04x Medicare
The contracted insurance negotiated median rate for a Total knee replacement at Saint Francis Hospital-Evanston is $13,691. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $13,690. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 1.04x the Medicare baseline. Located in 355 Ridge Ave, Evanston, IL.
Cash / Self-Pay
$13,690

Average discount available for prompt cash payment at this facility.

Insurance Median
$13,691

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: $13,690 (104%)
Insurance Median: $13,691 (104%)
Cash: $13,690 (104% of Medicare)
Ins. Median: $13,691 (104% 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
Ravenswood Physicians Associates Ipa $1,340 - $13,691 10%
Resurrection Physicians Provider Group Ipa $1,340 - $13,691 10%
Aetna $2,846 - $14,375 22%
Cigna $4,550 - $13,691 35%
Standard Eapg Logic - Contracts $11,907 91%
Blue Cross Blue Shield $11,914 - $19,167 91%
Countycare $11,914 91%
Humana $11,914 - $15,060 91%
Medicaid / KanCare $11,914 91%
Meridian $12,510 - $14,375 95%
Molina $12,510 - $20,536 95%
Celtic (Wellcare) $13,691 104%
Clear Spring Health Of Illinois $13,691 104%
Devoted Health $13,691 104%
Essential Health Partners $13,691 - $15,744 104%
Illinois Physicians Alliance $13,691 104%
Longevity Health Plan Of Illinois $13,691 104%
Medicare (plans) $13,691 104%
Self-Pay $13,691 104%
Tricare $13,691 104%
UnitedHealthcare $13,691 - $30,270 104%
Zing Health Provider Network $14,101 108%
Provider Partners Health Plan (Pphp) $14,375 110%
Access Community Health Network $16,429 125%
Clifton Health Systems $21,221 162%
Ambetter / Centene $22,179 169%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 355 Ridge Ave, Evanston, IL 60202
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals