Total knee replacement
Facility: Community Memorial Healthcare, Inc.
Billing Code: 27447 (CPT)
- CPT Billing Code: 27447
- Insurance Median: $1,387
- Cash Discount Price: $3,250
- 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 |
|---|---|---|
| Aetna | $1,056 - $1,613 | 8% |
| UnitedHealthcare | $1,161 | 9% |
| Blue Cross Blue Shield | $2,488 | 19% |
Consumer Guidance & Cost Commentary
For a total knee replacement at Community Memorial Healthcare in Marysville, KS, the cash price is $3,250, which matches the facility's cash median. While the Medicare benchmark for this procedure is significantly higher at $13,116.76, commercial insurance plans negotiate rates that often exceed the cash price. For instance, Aetna plans have a low-end negotiated rate of $1,056, while Blue Cross Blue Shield plans list a rate of $2,488. Because the cash price is lower than many of these negotiated amounts, patients with high-deductible plans or those who have already met their out-of-pocket maximum may find it financially advantageous to pay the $3,250 cash rate directly, provided they can secure a prompt-pay discount.
It is important to verify the specific negotiated rates for your insurance plan, as these vary by carrier and can differ significantly from the facility's general averages. Although the facility is a critical access hospital with a voluntary non-profit ownership structure, the data shows that commercial rates for this service are not uniformly lower than the cash option. To ensure you are receiving the best possible price, we recommend contacting the hospital directly to inquire about self-pay or prompt-pay discounts, which can range from 20% to 50% off the billed amount. Always request a formal itemized bill before finalizing payment to confirm that no unnecessary charges or unbundled codes have been applied to your account.