CMS Price Transparency Data

Total knee replacement

Facility: Rush Memorial Hospital

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $1,185
Cash Discount Price: $2,062
vs. Medicare Baseline: 0.09x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at Rush Memorial Hospital is $1,185. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,062. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.09x the Medicare baseline. Located in 1300 N Main St, Rushville, IN.

Cash / Self-Pay

$2,062

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,185

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: $2,062 (16%)

Insurance Median: $1,185 (9%)

Cash: $2,062 (16% of Medicare)

Ins. Median: $1,185 (9% 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
Cigna	$809 - $1,941	6%
Health Net	$809 - $1,941	6%
UnitedHealthcare	$924 - $1,062	7%
Caresource Mcr Adv	$1,062	8%
Aetna	$1,073 - $1,185	8%
Humana	$1,073 - $1,153	8%
Blue Cross Blue Shield	$1,094 - $2,089	8%
Today'S Option Mcr Adv-All Plans	$1,094	8%
Viant Beech St Mcr Adv	$1,094	8%
My True Advantage - All Plans	$1,115	9%
Coventry/First Health-All Plans	$1,132 - $2,717	9%
Consumers Life Ins-All Plans	$1,185	9%
Caresource Marketplace-All Other Plans	$1,434	11%
Multiplan-All Plans	$1,960	15%
Phcs-All Plans	$2,029	15%
Encore Health Services-All Plans	$2,133	16%
Siho-All Plans	$2,133	16%

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 $2,062.
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 Rush Memorial 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.