Total knee replacement
Facility: Providence Medical Center
Billing Code: 27447 (CPT)
- CPT Billing Code: 27447
- Insurance Median: $15,601
- Cash Discount Price: $12,095
- vs. Medicare Baseline: 1.19x 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 |
|---|---|---|
| Aetna | $734 - $12,095 | 6% |
| Comp Alliance - Fka Compresults Worker Compensation | $2,696 | 21% |
| UnitedHealthcare | $4,264 - $16,934 | 33% |
| Medicaid / KanCare | $4,264 | 33% |
| Celtic | $4,349 - $19,353 | 33% |
| Healthy Blue | $4,349 - $12,700 | 33% |
| Midland Care Connection | $12,095 | 92% |
| Cigna | $12,095 | 92% |
| Tricare | $12,095 | 92% |
| Medicare (plans) | $12,095 | 92% |
| Kansas Superior Select | $12,700 | 97% |
| Employer Direct Healthcare | $15,601 - $16,934 | 119% |
| Centurion | $15,601 - $18,143 | 119% |
| Oha Networks | $15,601 - $19,638 | 119% |
| Corizon | $15,601 - $15,724 | 119% |
| Well Path Prison | $15,601 - $16,934 | 119% |
| Worker Compensation | $15,601 - $20,246 | 119% |
| Naphcare | $15,601 - $18,748 | 119% |
| Blue Cross Blue Shield | $15,601 - $22,377 | 119% |
Consumer Guidance & Cost Commentary
For a total knee replacement at Providence Medical Center in Kansas City, KS, the cash price is $12,095, which is significantly lower than the facility's gross charge of $45,330. While many commercial payers negotiate rates ranging from $2,696 to $22,377, the cash rate remains the most predictable option for patients without insurance. It is important to note that cash payments can sometimes be cheaper than insurance claims if your plan has a high deductible or if the insurer's negotiated rate exceeds the cash price. To secure the lowest possible cost, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can bypass the administrative overhead and potential balance billing associated with insurance processing.
The facility's pricing is benchmarked against Medicare, which sets a baseline rate of $13,116.76 for this procedure. The cash price of $12,095 is below the Medicare amount, indicating a favorable rate structure compared to the federal government's cost-based reimbursement. However, commercial negotiated rates vary widely among the 19 payers, with some plans paying as low as $734 and others up to $22,377. Patients should be aware that balance billing may occur if they receive out-of-network care, though the No Surprises Act protects against surprise bills for emergency services at in-network facilities. If you receive a large bill after insurance processing, you have the right to request a formal itemized audit to identify errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain discrepancies that can be corrected through