CMS Price Transparency Data

Total knee replacement

Facility: Sparrow Ionia Hospital

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $12,302
Cash Discount Price: $4,210
vs. Medicare Baseline: 0.94x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at Sparrow Ionia Hospital is $12,302. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,210. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.94x the Medicare baseline. Located in 3565 S State Road, Ionia, MI.

Cash / Self-Pay

$4,210

Average discount available for prompt cash payment at this facility.

Insurance Median

$12,302

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: $4,210 (32%)

Insurance Median: $12,302 (94%)

Cash: $4,210 (32% of Medicare)

Ins. Median: $12,302 (94% 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
Medicaid / KanCare	$828	6%
Aetna	$1,233 - $6,998	9%
Medicare (plans)	$1,236 - $7,425	9%
Blue Cross Blue Shield	$2,275 - $17,552	17%
Covenant Advantage	$6,998	53%
Medigold	$6,998	53%
Senior Community Care	$6,998	53%
Humana	$7,348 - $22,674	56%
Priority	$17,179	131%
UnitedHealthcare	$21,471	164%
Cigna	$22,170	169%
Great West Healthcare	$22,170	169%
Asr	$22,394	171%
Blue Care Network	$22,394	171%
Health Alliance Plan	$22,394	171%
Cofinity	$22,674	173%
Mclaren Commercial	$24,942	190%

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 $4,210.
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 Sparrow Ionia 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.