CMS Price Transparency Data

Total knee replacement

Facility: Northwest Health - Porter

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27447
  • Insurance Median: $26,103
  • Cash Discount Price: $42,436
  • vs. Medicare Baseline: 1.99x Medicare
The contracted insurance negotiated median rate for a Total knee replacement at Northwest Health - Porter is $26,103. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $42,436. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 1.99x the Medicare baseline. Located in 85 East Us Hwy 6, Valparaiso, IN.
Cash / Self-Pay
$42,436

Average discount available for prompt cash payment at this facility.

Insurance Median
$26,103

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: $42,436 (324%)
Insurance Median: $26,103 (199%)
Cash: $42,436 (324% of Medicare)
Ins. Median: $26,103 (199% 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
One Call $1,062 8%
Veterans Eval Services $1,153 9%
Aetna $1,358 - $75,913 10%
UnitedHealthcare $6,159 - $26,103 47%
Blue Cross Blue Shield $13,346 - $55,360 102%
Humana $13,346 - $26,103 102%
Medicare (plans) $13,346 - $14,263 102%
Node Mhs Mcr Adv $13,346 102%
Healthy Indiana Plan $13,583 104%
Node Hospice Non Par Agree $13,583 104%
Node Va $13,583 104%
Node Devoted Health Mcr Adv $13,613 104%
Care Improvement Plus $14,014 107%
In Dept Of Correction $14,127 108%
Node Us Dept Of Labor $16,979 129%
Align Network $21,734 166%
One Call Work Comp $21,734 166%
Encore Health $24,450 - $125,736 186%
Prime Health $24,450 - $117,878 186%
Caresource $26,103 199%
Managed Health Services $26,103 - $27,167 199%
Medicaid / KanCare $26,103 199%
Mhs $26,103 199%
Indiana Work Comp $27,167 207%
Lutheran Preferred $27,167 - $94,302 207%
Node Encore Kba Epo $32,600 249%
Porter County $32,600 249%
Preferred Network Access $32,600 249%
Magnacare Ma $34,596 264%
Lutheran Preferred Chs Employees $37,721 288%
Self Pay $42,436 324%
Cigna $43,693 333%
Physicians Health Plan $60,228 459%
Php Freedom $64,927 495%
Sagamore Health Network $69,469 - $93,045 530%
First Health Coventry $77,014 587%
Encore Ppo $78,585 599%
Southeastem Indiana Health Operations $110,019 - $117,878 839%
Network Synergy Group $117,878 899%
Multiplan/Phcs $132,023 1007%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 85 East Us Hwy 6, Valparaiso, IN 46383
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals