CMS Price Transparency Data

Total knee replacement

Facility: Saint Joseph Regional Medical Center

Billing Code: 27447 (CPT)

The BaseRate · fair price low confidence

A fair price for this

$8,769

about 0.7× the $13,117 Medicare rate · typically $1,891–$24,737

modeled estimate · not a bill or quote

What this hospital charges insurers

$25,809

Well above the fair price

about $17,040 over the fair price · 2.0× Medicare

Medicare pays $13,117 Fair price $8,769 This hospital $25,809 Cash price $40,740

How we calculate the fair BaseRate →

How this hospital compares to other IN hospitals

Highest price of the 9 IN hospitals we have prices for — worth calling around.

Cheapest $2,964 Priciest $25,809

Black dot = this hospital, among the 9 IN hospitals with a price for this procedure. Full list below.

A fair price for a Total knee replacement is about $8,769 (about 0.7× the $13,117 Medicare rate). Saint Joseph Regional Medical Center charges insurers about $25,809, or about $40,740 in cash — well above the fair price. Located in Mishawaka, IN.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $8,769. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

3 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna CignaHumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$7,031 - $26,103	54%
Blue Cross Blue Shieldmajor	$7,031 - $47,957	54%
Aetnamajor	$7,031 - $21,054	54%
CareSource	$21,054	161%
Meridian	$13,583	104%
+ 14 smaller / regional plans	$13,583 - $47,957

Government programs also on file: Medicare, Medicaid.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 40,740), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 27447.

Insurance Before you use insurance

Call your insurance company to confirm Saint Joseph Regional Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 27447.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Saint Joseph Regional Medical Center

Compare: Total knee replacement at other IN hospitals

Memorial Hospital and Health Care Center · Jasper $2,964
Greene County General Hospital · Linton $6,051
Pinnacle Hospital · Crown Point $7,516
Goshen Hospital · Goshen $12,409
Norton Scott Hospital · Scottsburg $13,253
Norton-King's Daughters' Health · Madison $13,479
Columbus Regional Hospital · Columbus $13,479
Marion General Hospital · Marion $13,528

Insurance negotiated median for the same procedure, sorted lowest first.