CMS Price Transparency Data

Total knee replacement

Facility: Mount Desert Island Hospital

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $2,219
Cash Discount Price: $3,195
vs. Medicare Baseline: 0.17x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at Mount Desert Island Hospital is $2,219. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,195. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.17x the Medicare baseline. Located in 10 Wayman Lane, Bar Harbor, ME.

Cash / Self-Pay

$3,195

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,219

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: $3,195 (24%)

Insurance Median: $2,219 (17%)

Cash: $3,195 (24% of Medicare)

Ins. Median: $2,219 (17% 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
Cigna	$1,598 - $3,302	12%
Wellcare	$1,598	12%
Aetna	$1,598 - $3,248	12%
Blue Cross Blue Shield	$1,598 - $2,762	12%
Martins Point	$1,598	12%
UnitedHealthcare	$1,598 - $2,130	12%
Healthnet	$2,308	18%
Community Health Options	$3,018	23%
Harvard Pilgrim	$3,213	24%
First Health	$3,372	26%

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 $3,195.
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 Mount Desert Island Hospital 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.