CMS Price Transparency Data

Total knee replacement

Facility: Witham Health Services

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $1,391
Cash Discount Price: $861
vs. Medicare Baseline: 0.11x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at Witham Health Services is $1,391. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $861. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.11x the Medicare baseline. Located in 2605 N Lebanon St, Lebanon, IN.

Cash / Self-Pay

$861

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,391

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: $861 (7%)

Insurance Median: $1,391 (11%)

Cash: $861 (7% of Medicare)

Ins. Median: $1,391 (11% 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
Blue Cross Blue Shield	$191 - $13,584	1%
Aetna	$228 - $13,991	2%
UnitedHealthcare	$240 - $2,660	2%
Phcs/Multiplan-All Plans	$280 - $3,103	2%
Sagamore-All Plans	$283 - $3,138	2%
Humana	$286 - $3,172	2%
Beech Street-All Plans	$289 - $3,206	2%
Encore-All Plans	$292 - $3,240	2%
Mhs Comml Exch-All Plans	$769 - $8,526	6%
Mdwise Health In-All Plans	$13,584	104%
Caresource Mcr Adv	$13,855	106%
Caresource Indiana Marketplace-All Other Plans	$25,809	197%

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 $861.
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 Witham Health Services 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.