Total knee replacement
Facility: Girard Medical Center
Billing Code: 27447 (CPT)
- CPT Billing Code: 27447
- Insurance Median: $1,056
- Cash Discount Price: $2,469
- vs. Medicare Baseline: 0.08x 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 |
|---|---|---|
| Kansas Superior Select-All Plans | $1,056 | 8% |
| Medicare (plans) | $1,056 | 8% |
| Humana | $1,056 | 8% |
| Blue Cross Blue Shield | $1,056 | 8% |
| UnitedHealthcare | $1,056 - $1,598 | 8% |
| Aetna | $1,056 | 8% |
| Ambetter / Centene | $1,056 | 8% |
| Uhhis-All Plans | $1,598 | 12% |
| Multiplan-All Plans | $3,806 | 29% |
Consumer Guidance & Cost Commentary
For a total knee replacement at Girard Medical Center in Girard, KS, the cash median price is $2,469, while the median negotiated rate across nine payers is $1,056. This facility, a Critical Access Hospital owned by a government hospital district, reports a Medicare amount of $13,116.76, which serves as a key benchmark for evaluating commercial pricing. While the negotiated rate of $1,056 is significantly lower than the cash price, patients with high-deductible plans or those without insurance may find the cash price more advantageous, as the negotiated rate often exceeds the cash price when administrative costs and claim processing are factored in. It is important to note that the cash median of $2,469 is lower than the facility's gross charge of $4,115, suggesting potential savings for self-pay patients who secure a self-pay or prompt-pay discount before treatment.
Pricing transparency for this procedure shows that while most major payers, including Medicare, Humana, and Blue Cross Blue Shield, have a consistent allowed amount of $1,056, UnitedHealthcare and Uhhis-All Plans have higher ranges, with UnitedHealthcare's three plans ranging from $1,056 to $1,598. When comparing these rates to the broader market, the facility's negotiated rate of $1,056 aligns with the lowest end of the spectrum observed among the nine payers, though the data does not provide specific county or state average figures for direct comparison. Patients should be aware that balance billing is generally prohibited for emergency care and non-emergency services at in-network facilities under the No