Total knee replacement
Facility: Clay County Medical Center
Billing Code: 27447 (CPT)
- CPT Billing Code: 27447
- Insurance Median: $19,057
- Cash Discount Price: $11,739
- vs. Medicare Baseline: 1.45x 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 |
|---|---|---|
| Multiplan- All Plans | $1,220 - $19,467 | 9% |
| UnitedHealthcare | $1,707 - $19,467 | 13% |
| Aetna | $19,057 | 145% |
| Wppa/Providrs Care- All Plans | $19,057 | 145% |
| Health Partners - All Plans | $19,467 | 148% |
Consumer Guidance & Cost Commentary
For a total knee replacement at Clay County Medical Center in Clay Center, KS, the cash price is $11,739, which matches the cash median for this procedure in the state. While the facility is a Critical Access Hospital with government ownership, the negotiated rates vary significantly by insurer, ranging from $1,220 to $19,467. Notably, the median negotiated rate of $19,057 is higher than the cash price, meaning patients with high-deductible plans might save money by paying cash directly, provided they can afford the upfront cost. It is important to verify if the facility offers "self-pay" or "prompt-pay" discounts, as paying in full upfront can sometimes bypass administrative fees and reduce the final amount owed.
When evaluating the cost against federal standards, the Medicare benchmark for this service is $13,116.76. The facility's cash rate of $11,739 is lower than the Medicare amount, while the median negotiated rate of $19,057 exceeds it by approximately 45%. This markup reflects the administrative costs and contract structures inherent in commercial insurance billing, which often run 200% to 300% of Medicare rates. To ensure you are receiving the most accurate pricing, always request an itemized bill before paying, as summary invoices may obscure individual charges or unbundled codes. Additionally, if you have out-of-network services, be aware that the No Surprises Act protects you from balance billing for emergency care and non-emergency services at in-network facilities, so do not sign away these rights without fully understanding the terms.