Total knee replacement
Facility: Susan B Allen Memorial Hospital
Billing Code: 27447 (CPT)
- CPT Billing Code: 27447
- Insurance Median: $554
- Cash Discount Price: $8,259
- vs. Medicare Baseline: 0.04x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| UnitedHealthcare | $350 | 3% |
| Providrs Care | $757 | 6% |
Consumer Guidance & Cost Commentary
For a total knee replacement at Susan B Allen Memorial Hospital in El Dorado, KS, the cash median price is $8,259, which is significantly lower than the facility's gross charge of $12,706. While the hospital's negotiated rates for UnitedHealthcare and Providrs Care are set at $350 and $757 respectively, these amounts are notably lower than the Medicare benchmark of $13,116.76. Under Medicare benchmarking principles, commercial rates often average 200% to 300% of Medicare, but this facility's negotiated rates appear to be well below that typical markup range. Patients with high-deductible plans may find the cash price of $8,259 more cost-effective than their insurance negotiated rate if the deductible has not yet been met, as paying out-of-pocket avoids the administrative overhead and potential underpayment risks associated with complex insurance claims.
It is important to verify the specific status of your insurance plan before scheduling, as assumed in-network rates do not guarantee the lowest possible price. The facility offers a median negotiated rate of $554, which is substantially lower than the cash price, suggesting that if your insurance covers this service, the negotiated amount may be the most financially prudent option. However, if you are self-pay or have a plan with a high deductible, you should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% when paid upfront. Additionally, since the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, you can confidently request an itemized billing audit if