Total knee replacement
Facility: Kansas Spine & Specialty Hospital, Llc
Billing Code: 27447 (CPT)
- CPT Billing Code: 27447
- Insurance Median: $11,773
- Cash Discount Price: $4,529
- vs. Medicare Baseline: 0.90x 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 |
|---|---|---|
| Humana | $11,537 | 88% |
| UnitedHealthcare | $11,773 - $14,245 | 90% |
| Providrs Care Network | $11,773 | 90% |
| Blue Cross Blue Shield | $11,773 - $12,000 | 90% |
| Aetna | $11,773 - $14,716 | 90% |
| United Mine Workers Of America | $11,773 | 90% |
| Lantern Specialty Care | $18,837 | 144% |
Consumer Guidance & Cost Commentary
For a total knee replacement at Kansas Spine & Specialty Hospital in Wichita, the cash median price is $4,529, which is significantly lower than the facility's negotiated rates and the Medicare benchmark of $13,116.76. While the hospital's negotiated average is $11,773, commercial payers like UnitedHealthcare and Aetna have allowed amounts ranging from $11,773 to $14,716, meaning insurance coverage could result in higher out-of-pocket costs if your deductible is not met. Because commercial rates often exceed cash prices due to administrative overhead and contract structures, patients with high-deductible plans may save money by paying the cash price directly, provided they verify the facility's "self-pay" or "prompt-pay" discounts before scheduling.
It is important to compare these rates against the objective baseline of Medicare, which represents the true cost of care rather than the inflated chargemaster list. Although the facility is a physician-owned acute care hospital, the gap between the Medicare rate and the commercial negotiated rates highlights how administrative costs and network tiering can increase final costs. To ensure you are not overpaying, request a full itemized billing audit to identify any unbundled codes or services not rendered, and always confirm your deductible status before relying on insurance to cover the procedure.