CMS Price Transparency Data

Total knee replacement

Facility: UW Health

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $1,202
Cash Discount Price: $1,779
vs. Medicare Baseline: 0.09x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at UW Health is $1,202. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,779. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.09x the Medicare baseline. Located in 1401 East State Street, Rockford, IL.

Cash / Self-Pay

$1,779

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,202

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: $1,779 (14%)

Insurance Median: $1,202 (9%)

Cash: $1,779 (14% of Medicare)

Ins. Median: $1,202 (9% 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
Aetna	$1,202 - $2,264	9%
Blue Cross Blue Shield	$1,202 - $11,117	9%
Humana	$1,202	9%
Medicare (plans)	$1,202 - $1,322	9%
Mychoice Wi Medical Adv	$1,202	9%
UnitedHealthcare	$1,202 - $2,337	9%
Medicaid / KanCare	$1,270	10%
Cigna	$2,343	18%
Quartz Fully Insured	$2,537	19%
Alliance Premier Network	$2,557	19%
The Alliance	$2,752	21%
Quartz Aso	$2,865	22%
Ecoh	$3,076 - $3,535	23%
Hfn	$3,076 - $3,535	23%
Wps	$5,559	42%
Beloit Healt System	$6,448	49%
Workers Comp	$6,856	52%
Mercy Care	$7,782	59%

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 $1,779.
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 UW Health 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.