CMS Price Transparency Data

Total knee replacement

Facility: St Joseph Health System, LLC

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27447
  • Insurance Median: $1,771
  • Cash Discount Price: $936
  • vs. Medicare Baseline: 0.14x Medicare
The contracted insurance negotiated median rate for a Total knee replacement at St Joseph Health System, LLC is $1,771. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $936. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.14x the Medicare baseline. Located in 702 Van Buren St., Fort Wayne, IN.
Cash / Self-Pay
$936

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,771

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: $936 (7%)
Insurance Median: $1,771 (14%)
Cash: $936 (7% of Medicare)
Ins. Median: $1,771 (14% 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
Amish Aid $195 - $1,171 1%
Self Pay $195 - $2,683 1%
Php $203 - $1,949 2%
Lutheran Preferred $232 - $2,927 2%
Php Freedom Network $255 - $1,529 2%
Cigna $263 - $4,878 2%
Blue Cross Blue Shield $295 - $55,822 2%
Lutheran Network $366 - $27,167 3%
Three Rivers $366 - $2,195 3%
Aetna $374 - $13,346 3%
Encore Ppo $415 - $4,390 3%
Sagamore $424 - $2,639 3%
Multiplan $561 - $3,805 4%
First Health $610 - $3,658 5%
Prime Health Services $610 - $24,450 5%
Align Network $650 - $3,902 5%
Frontpath Health Coalition $650 - $3,902 5%
Advantage Health Solutions $675 - $4,049 5%
Allied Benefit Systems $732 - $4,390 6%
Medical Mutual Of Ohio $813 - $4,878 6%
Parkview Healthplan Services $813 - $4,878 6%
Value Options $813 - $4,878 6%
Veterans Eval Services $813 - $1,153 6%
UnitedHealthcare $12,012 - $13,583 92%
Humana $13,346 102%
Managed Health Services $13,346 - $27,167 102%
Medicare (plans) $13,346 102%
Node Hospice Non Par Agree $13,583 104%
Node Va $13,583 104%
Node Devoted Health Mcr Adv $13,613 104%
In Dept Of Correction $14,127 108%
Node Pphp Mcr Adv $14,263 109%
Us Department Of Labor $16,979 129%
Lutheran Advanced Network $20,375 155%
Encore Work Comp In $24,450 186%
Work Comp $27,167 207%
Encore Kba Epo $32,600 249%
Encore Kba Ppo $40,750 311%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 702 Van Buren St., Fort Wayne, IN 46802
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals