CMS Price Transparency Data

Total knee replacement

Facility: HSHS St Elizabeth's Hospital

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27447
  • Insurance Median: $14,965
  • Cash Discount Price: $12,676
  • vs. Medicare Baseline: 1.14x Medicare
The contracted insurance negotiated median rate for a Total knee replacement at HSHS St Elizabeth's Hospital is $14,965. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $12,676. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 1.14x the Medicare baseline. Located in One St Elizabeth Boulevard, O Fallon, IL.
Cash / Self-Pay
$12,676

Average discount available for prompt cash payment at this facility.

Insurance Median
$14,965

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: $12,676 (97%)
Insurance Median: $14,965 (114%)
Cash: $12,676 (97% of Medicare)
Ins. Median: $14,965 (114% 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
Amish Community $4,930 38%
Molina Healthcare $8,639 - $15,036 66%
Meridian Health Plan $9,050 - $13,575 69%
Wellfirst $11,336 86%
Aetna $11,532 - $14,365 88%
First Health $13,098 100%
Health Alliance Medical Plans $13,204 - $14,965 101%
Cigna $13,908 - $17,605 106%
Healthlink $13,996 - $17,605 107%
Caterpillar, Inc. $14,137 108%
UnitedHealthcare $14,137 - $17,605 108%
Blue Cross Blue Shield $14,365 - $17,605 110%
Clear Spring Health Of Illinois $14,365 110%
Health Partners $14,365 110%
Humana $14,365 110%
Sae Hospice $14,365 110%
Consociate Group $15,493 118%
Choicecare $15,845 121%
Healthcare Finest Network (Hfn) $15,845 121%
Multiplan/Phcs $15,845 121%
Provider Network Of America $15,845 121%
Celtic Insurance Company $17,605 134%
City Of Springfield $17,605 134%
Claim Doc $17,605 134%
Current Health Solutions $17,605 134%
Healthscope $17,605 134%
Hopetrust $17,605 134%
Illinois Breast And Cervical Cancer Program $17,605 134%
Interplan $17,605 134%
Live360 $17,605 134%
Wexford $17,605 134%
Naphcare $31,131 237%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One St Elizabeth Boulevard, O Fallon, IL 62269
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals