CMS Price Transparency Data

Total knee replacement

Facility: Trinity Health Muskegon Hospital

Billing Code: 27447 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$5,469

about 0.4× the $13,117 Medicare rate · typically $2,554–$15,829

modeled estimate · not a bill or quote

What this hospital charges insurers

$20,452

Well above the fair price

about $14,983 over the fair price · 1.6× Medicare

Medicare pays $13,117 Fair price $5,469 This hospital $20,452 Cash price $45,061

How we calculate the fair BaseRate →

How this hospital compares to other MI hospitals

Highest price of the 9 MI hospitals we have prices for — worth calling around.

Cheapest $2,893 Priciest $20,452

Black dot = this hospital, among the 9 MI hospitals with a price for this procedure. Full list below.

A fair price for a Total knee replacement is about $5,469 (about 0.4× the $13,117 Medicare rate). Trinity Health Muskegon Hospital charges insurers about $20,452, or about $45,061 in cash — well above the fair price. Located in Muskegon, MI.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $5,469. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Kaiser Permanente CignaHumana

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$14,112	108%
Blue Cross Blue Shieldmajor	$7,171 - $25,565	55%
Aetnamajor	$13,427	102%
Kaiser Permanentemajor	$20,452 - $25,565	156%
Molina	$17,811	136%
Oscar Health	$17,537	134%
Priority Health	$15,363 - $34,376	117%
+ 12 smaller / regional plans	$2,764 - $25,565

Government programs also on file: Medicare, Medicaid.

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 45,061), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 27447.

Insurance Before you use insurance

Call your insurance company to confirm Trinity Health Muskegon Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 27447.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Trinity Health Muskegon Hospital

Compare: Total knee replacement at other MI hospitals

Beaumont Hospital - Grosse Pointe · Grosse Pointe $2,893
Henry Ford Health Warren Hospital · Warren $3,190
Ascension River District Hospital · East China $3,190
Beaumont Hospital, Troy · Troy $3,262
Ascension Genesys Hospital · Grand Blanc $11,056
Straith Hospital for Special Surgery · Southfield $11,513
Corewell Health Wayne Hospital · Wayne $11,902
Corewell Health Trenton Hospital · Trenton $11,902

Insurance negotiated median for the same procedure, sorted lowest first.