CMS Price Transparency Data

Total knee replacement

Facility: Pulaski Memorial Hospital

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $1,155
Cash Discount Price: $2,024
vs. Medicare Baseline: 0.09x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at Pulaski Memorial Hospital is $1,155. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,024. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.09x the Medicare baseline. Located in 616 E 13Th St, Winamac, IN.

Cash / Self-Pay

$2,024

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,155

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: $2,024 (15%)

Insurance Median: $1,155 (9%)

Cash: $2,024 (15% of Medicare)

Ins. Median: $1,155 (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
Ambetter / Centene	$1,062	8%
Blue Cross Blue Shield	$1,062 - $2,089	8%
Caresource Mcaid Hip	$1,062	8%
Caresource Mcare Hmo	$1,062	8%
Cenpatico Mcaid Hip	$1,062	8%
Humana	$1,062 - $1,588	8%
Mhs Mcaid Hip	$1,062	8%
Mhs Mcare Allwell	$1,062	8%
Multiplan - All Plans	$1,062	8%
UnitedHealthcare	$1,062 - $1,157	8%
Caresource Mcaid Hhw	$1,153	9%
Cenpatico Mcaid Hhw - All Other Plans	$1,153	9%
Mhs Mcaid Hhw/Hcc	$1,153	9%
Mdwise Mcaid Hcc	$1,157	9%
Mdwise Mcaid Hhw	$1,157	9%
Mdwise Mcaid Hip - All Other Plans	$1,157	9%
Caresource Exch Hmo Hix - All Other Plans	$1,328	10%
Encore Ppo - All Other Plans	$1,434	11%
Cigna	$1,726	13%
Sagamore - All Other Plans	$1,726	13%
Sagamore Rose Acre	$1,726	13%
Community Health Alliance - All Plans	$2,565	20%
Encore Workers Comp	$2,603	20%

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 $2,024.
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 Pulaski 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.