Total knee replacement
Facility: Holton Community Hospital
Billing Code: 27447 (CPT)
- CPT Billing Code: 27447
- Insurance Median: $14,769
- Cash Discount Price: $11,648
- vs. Medicare Baseline: 1.13x 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 | $1,056 - $27,590 | 8% |
| Aetna | $1,056 - $27,590 | 8% |
| Humana | $1,066 - $14,769 | 8% |
| Kansas Superior Select - All Plans | $1,077 - $14,915 | 8% |
| Medicaid / KanCare | $1,156 - $27,590 | 9% |
| Blue Cross Blue Shield | $7,866 | 60% |
| Preferred Health Freedom | $22,900 | 175% |
| Preferred Health Fn Select - All Other Plans | $22,900 | 175% |
| Preferred Health Professionals | $22,900 | 175% |
| Wppa Providers - All Plans | $26,210 | 200% |
Consumer Guidance & Cost Commentary
For a total knee replacement at Holton Community Hospital in Holton, Kansas, the facility's cash price of $11,648 is lower than the median negotiated rate of $14,769 paid by insurers. While the gross chargemaster lists at $15,530, patients with high-deductible plans may find paying cash directly more cost-effective if their insurance negotiated rate exceeds the cash price. It is important to note that commercial payers like UnitedHealthcare and Aetna have negotiated rates ranging from $1,056 to $27,590, which can vary significantly based on specific plan tiers and network status.
This facility, a Critical Access Hospital in a rural area (ZIP 66436), operates with a voluntary non-profit ownership structure. The Medicare benchmark for this procedure is $13,116.76, which serves as a reliable baseline for evaluating pricing fairness, as commercial rates often exceed this federal standard due to administrative overhead and contract dynamics. Patients should verify their specific plan's allowed amount before scheduling, as in-network rates are not uniform across all insurers. Additionally, asking about "self-pay" or "prompt-pay" discounts prior to check-in can help secure lower rates, as hospitals often offer fee reductions for upfront payments that bypass the higher administrative costs associated with insurance billing.