Total knee replacement
Facility: Wamego Health Center
Billing Code: 27447 (CPT)
- CPT Billing Code: 27447
- Insurance Median: $761
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.06x 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 | $550 - $747 | 4% |
| Aetna | $572 - $776 | 4% |
| Medicaid / KanCare | $572 - $776 | 4% |
| Providrs Care | $1,562 | 12% |
| Blue Cross Blue Shield | $20,703 - $21,792 | 158% |
Consumer Guidance & Cost Commentary
For a total knee replacement at Wamego Health Center in Wamego, Kansas, the negotiated rates for major payers like UnitedHealthcare, Aetna, and Medicaid/KanCare range from $550 to $776, while Blue Cross Blue Shield rates are significantly higher at $20,703 to $21,792. These commercial rates are substantially lower than the Medicare benchmark of $13,116.76, which serves as the federal standard for the true cost of care. While cash payments are not listed in this report, patients should note that paying out-of-pocket can sometimes be more cost-effective than using insurance if the negotiated rate exceeds the cash price, particularly for those with high-deductible plans. It is always advisable to contact the facility directly to inquire about self-pay or prompt-pay discounts, which can further reduce the final amount owed.
Patients should be aware that commercial insurance contracts often set a maximum allowed amount that is higher than the actual cost of care, a dynamic that can lead to unexpected balance billing if services are rendered out-of-network. Although the No Surprises Act protects patients from balance billing for emergency and non-emergency services at in-network facilities, it is crucial to verify network status before scheduling. If a patient receives a bill that appears to include charges for services not rendered or unbundled components, they should request a formal itemized audit to identify errors before making a payment. Disputing these errors in writing ensures that the patient is only responsible for the accurate, contracted amount rather than inflated charges.