CMS Price Transparency Data

Total knee replacement

Facility: Hiawatha Community Hospital

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27447
  • Insurance Median: $1,583
  • Cash Discount Price: $2,767
  • vs. Medicare Baseline: 0.12x Medicare
The contracted insurance negotiated median rate for a Total knee replacement at Hiawatha Community Hospital is $1,583. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,767. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.12x the Medicare baseline. Located in 300 Utah Street, Hiawatha, KS.
Cash / Self-Pay
$2,767

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,583

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$13,116.76

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $13,116.76 (100%)
Cash / Self-Pay: $2,767 (21%)
Insurance Median: $1,583 (12%)
Cash: $2,767 (21% of Medicare)
Ins. Median: $1,583 (12% of 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.

Input your details and click calculate to compare out-of-pocket costs.

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 - $1,720 8%
Aetna $1,056 - $1,662 8%
Humana $1,056 8%
Ambetter / Centene $1,094 8%
Centrus Health Direct - All Plans $1,267 10%
Healthy Blue Mcaid - All Plans $1,406 - $4,128 11%
Wppa Providrs Care - All Plans $1,492 11%
Multiplan - All Plans $1,583 12%
Oscar - All Plans $1,689 13%
Preferred Hlth - All Plans $1,892 14%
Cigna $2,742 21%
Midlands Choice - All Plans $2,994 23%

Consumer Guidance & Cost Commentary

For a total knee replacement at Hiawatha Community Hospital in Hiawatha, KS, the cash price is $2,767, which is significantly lower than the facility's negotiated rates with major insurers like UnitedHealthcare ($1,056–$1,720) and Aetna ($1,056–$1,662). This cash rate is also notably lower than the Medicare benchmark of $13,116.76, indicating a substantial markup on commercial contracts. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that commercial negotiated rates often include administrative overhead and contract dynamics that can exceed the actual cost of care. If you have a high-deductible plan, paying the cash price directly might result in lower out-of-pocket costs compared to your insurance's negotiated allowed amount, provided you have not yet met your deductible.

To ensure you are receiving the most accurate pricing, always request an itemized bill before finalizing payment, as summary bills can obscure individual charges or unbundled services. If you choose to pay out-of-pocket, ask the billing department about prompt-pay discounts, which can reduce the total by 20% to 50% if settled within 30 days. Additionally, verify that your specific plan is in-network and check your deductible status, as assuming an in-network rate is the best price can lead to unexpected costs if your plan has not covered the service. Finally, if you receive a bill that seems inconsistent with the data above, do not accept a verbal dispute resolution; instead, request a written itemized audit to identify any errors, double-billing, or services not rendered

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 Utah Street, Hiawatha, KS 66434
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals