CMS Price Transparency Data

Total knee replacement

Facility: Holyoke Medical Center

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $14,815
Cash Discount Price: $11,142
vs. Medicare Baseline: 1.13x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at Holyoke Medical Center is $14,815. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $11,142. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 1.13x the Medicare baseline. Located in 575 Beech Street, Holyoke, MA.

Cash / Self-Pay

$11,142

Average discount available for prompt cash payment at this facility.

Insurance Median

$14,815

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: $11,142 (85%)

Insurance Median: $14,815 (113%)

Cash: $11,142 (85% of Medicare)

Ins. Median: $14,815 (113% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Tufts Health Public Plans	$5,496 - $16,932	42%
Bmchp	$6,463	49%
Fallon	$6,463 - $15,521	49%
Health New England	$6,463 - $14,110	49%
Wellsense Direct Metals Silver	$8,079	62%
Tufts Health Plan	$12,879 - $14,110	98%
Aetna	$14,110	108%
Blue Cross Blue Shield	$14,110 - $17,275	108%
UnitedHealthcare	$14,110 - $16,071	108%
Commonwealth Care Alliance	$14,815	113%
Wellsense Sco	$14,956	114%
Wellcare	$15,095	115%
Harvard Pilgrim	$16,071	123%
Senior Whole Health	$16,226	124%
Cigna	$17,609	134%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $11,142.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 27447.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Holyoke Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 27447.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.