CMS Price Transparency Data

Total knee replacement

Facility: Marion General Hospital

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $13,528
Cash Discount Price: $71,043
vs. Medicare Baseline: 1.03x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at Marion General Hospital is $13,528. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $71,043. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 1.03x the Medicare baseline. Located in 441 N Wabash Ave, Marion, IN.

Cash / Self-Pay

$71,043

Average discount available for prompt cash payment at this facility.

Insurance Median

$13,528

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: $71,043 (542%)

Insurance Median: $13,528 (103%)

Cash: $71,043 (542% of Medicare)

Ins. Median: $13,528 (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.

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	$13,528	103%
Blue Cross Blue Shield	$13,528 - $42,857	103%
Cigna	$13,528	103%
Humana	$13,528	103%
Lasso_Healthcare	$13,528	103%
Medicare (plans)	$13,528 - $20,292	103%
Exchange_Ambest_Mhs	$20,292	155%
Exchange_Caresource	$20,292	155%
Exchange_Caresource_Observatio	$20,292	155%
Managed_Hlth_Indiana	$20,292	155%
Exchange_Blue_Cross	$39,000	297%

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 $71,043.
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 Marion General 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.