Total knee replacement
Facility: Cloud County Health Center
Billing Code: 27447 (CPT)
- CPT Billing Code: 27447
- Insurance Median: $1,425
- Cash Discount Price: $2,325
- vs. Medicare Baseline: 0.11x 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 |
|---|---|---|
| Pponext-All Plans | $724 - $5,586 | 6% |
| Mpi-All Plans | $1,425 | 11% |
Consumer Guidance & Cost Commentary
For a total knee replacement at Cloud County Health Center in Concordia, KS, the facility's cash price of $2,325 is lower than the state average for this procedure. While the facility's negotiated rate with Mpi-All Plans is $1,425, this amount is significantly higher than the cash price, illustrating that paying out-of-pocket can sometimes be more cost-effective for patients with high-deductible plans or those without insurance. The facility's gross charge of $3,321 serves as the baseline, but patients should verify if "self-pay" or "prompt-pay" discounts are available before scheduling, as these upfront fee reductions can bypass the administrative costs associated with insurance billing cycles.
It is important to understand that the facility's negotiated rate does not represent the lowest possible price, as commercial rates often include administrative markups that can inflate the baseline by 20% to 40%. If you have insurance, you should check your deductible status before using it, as paying the negotiated rate without meeting your deductible could result in higher out-of-pocket costs than paying cash. Additionally, if you receive care from an out-of-network provider at this in-network facility, the No Surprises Act protects you from balance billing for emergency services and non-emergency services from out-of-network providers at in-network facilities. Always request a full itemized bill before paying any invoice to ensure there are no errors, double-billing, or unbundled codes that could be disputed.