CMS Price Transparency Data

Total knee replacement

Facility: Morris County Hospital

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27447
  • Insurance Median: $12,629
  • Cash Discount Price: $9,140
  • vs. Medicare Baseline: 0.96x Medicare
The contracted insurance negotiated median rate for a Total knee replacement at Morris County Hospital is $12,629. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $9,140. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.96x the Medicare baseline. Located in 600 N Washington St, Council Grove, KS.
Cash / Self-Pay
$9,140

Average discount available for prompt cash payment at this facility.

Insurance Median
$12,629

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: $9,140 (70%)
Insurance Median: $12,629 (96%)
Cash: $9,140 (70% of Medicare)
Ins. Median: $12,629 (96% 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
Va Ccn-All Plans $5,941 45%
Choice Care Mcr Adv-All Plans $5,941 45%
UnitedHealthcare $5,941 - $15,234 45%
Blue Cross Blue Shield $5,941 - $16,084 45%
Coventry Mcr $5,941 45%
Cigna $11,020 84%
Aetna $13,650 104%
Multiplan-All Plans $13,711 105%
Coventry Comm-All Other Plans $13,711 105%
Providrs Care (Wppa)(Nexus)-All Plans $22,851 174%

Consumer Guidance & Cost Commentary

For a total knee replacement at Morris County Hospital in Council Grove, KS, the cash price of $9,140 is significantly lower than the facility's gross charge of $15,234. While the hospital's negotiated rates with major payers like UnitedHealthcare and Blue Cross Blue Shield range from $5,941 to $16,084, the cash rate remains the most transparent baseline for comparison. It is important to note that cash payments can sometimes be the most cost-effective option for patients with high-deductible plans, as the $9,140 cash price is lower than the median negotiated rate of $12,629. To secure the lowest possible cost, patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed before insurance processing begins.

When evaluating the true cost of this procedure, it is essential to compare rates against the Medicare benchmark rather than the inflated chargemaster list. The Medicare amount for this code is $13,116.76, which serves as the scientifically validated baseline for fair pricing; commercial negotiated rates typically average between 200% and 300% of this figure, while fair pricing is generally defined as 120% to 150%. Although the facility is a Critical Access Hospital with a government-local ownership structure, patients should verify their specific plan's deductible status before scheduling, as paying the full negotiated rate without meeting the deductible can result in higher out-of-pocket expenses than paying the cash rate directly.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 600 N Washington St, Council Grove, KS 66846
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals