CMS Price Transparency Data

Total knee replacement

Facility: Anderson Hospital

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27447
  • Insurance Median: $13,518
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.03x Medicare
The contracted insurance negotiated median rate for a Total knee replacement at Anderson Hospital is $13,518. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 1.03x the Medicare baseline. Located in 6800 State Route 162, Maryville, IL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$13,518

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%)
Insurance Median: $13,518 (103%)
Ins. Median: $13,518 (103% 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
Medicaid / KanCare $1,049 - $11,908 8%
Humana $1,245 - $13,518 9%
Medicare (plans) $1,245 - $13,518 9%
UnitedHealthcare $1,245 - $13,518 9%
Tricare $1,305 - $50,000 10%
Work Comp $4,971 38%
Blue Cross Blue Shield $6,640 51%
Aetna $13,518 103%
Essence $13,758 - $14,171 105%
Devoted Health Ppo $13,788 105%
Clear Springs Health $13,923 106%
Ambetter / Centene $19,949 152%
Blue Choice $19,949 152%
Self Pay $25,000 191%
Hopetrust $34,395 262%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6800 State Route 162, Maryville, IL 62062
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals