Total knee replacement
Facility: Pratt Regional Medical Center
Billing Code: 27447 (CPT)
- CPT Billing Code: 27447
- Insurance Median: $2,715
- Cash Discount Price: $1,879
- vs. Medicare Baseline: 0.21x 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 |
|---|---|---|
| Christian Health Aid | $679 - $2,715 | 5% |
| UnitedHealthcare | $753 - $13,418 | 6% |
| Health Partners Of Kansas | $769 - $3,077 | 6% |
| Aetna | $815 - $3,258 | 6% |
| Choicecare | $905 - $3,620 | 7% |
| Celtic Insurance Company | $12,198 | 93% |
| Healthy Blue | $12,564 | 96% |
Consumer Guidance & Cost Commentary
For a total knee replacement at Pratt Regional Medical Center in Pratt, Kansas, the cash median price is $1,879, which is significantly lower than the facility's negotiated rates and the Medicare benchmark of $13,116.76. While commercial payers like UnitedHealthcare and Celtic Insurance Company have negotiated rates ranging from $753 to over $12,000, patients with high-deductible plans may find the cash price more advantageous if their insurance allowed amount exceeds the cash rate. It is important to note that the facility's cash price is well below the typical commercial markup seen in many markets, where negotiated rates often average 200% to 300% of Medicare, whereas fair pricing is generally defined as 120% to 150% of the Medicare rate.
To maximize savings, patients should verify if the hospital offers a "prompt-pay" discount, which can reduce the bill by 20% to 50% for upfront payment and bypass costly insurance billing cycles. Before scheduling, it is crucial to confirm that the facility is in-network to avoid balance billing, though the No Surprises Act protects patients from unexpected out-of-network charges for emergency care and certain services at in-network facilities. Since over 80% of hospital bills contain errors, patients should request a full itemized CPT-coded statement rather than accepting a summary bill, ensuring they can identify any unbundled codes or services not rendered before finalizing payment.