CMS Price Transparency Data

Total knee replacement

Facility: St Lukes Hospital

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $4,397
Cash Discount Price: $7,154
vs. Medicare Baseline: 0.34x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at St Lukes Hospital is $4,397. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,154. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.34x the Medicare baseline. Located in 915 East 1St Street, Duluth, MN.

Cash / Self-Pay

$7,154

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,397

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: $7,154 (55%)

Insurance Median: $4,397 (34%)

Cash: $7,154 (55% of Medicare)

Ins. Median: $4,397 (34% 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
UnitedHealthcare	$254 - $1,537	2%
Blue Cross Blue Shield	$269 - $42,632	2%
Aetna	$277 - $13,691	2%
Ucare	$299	2%
Medica	$305 - $404	2%
Security Health Plan Of Wisconsin, Inc.	$310 - $13,221	2%
Humana	$332 - $13,957	3%
Healthpartners	$1,180 - $13,558	9%

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 $7,154.
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 St Lukes 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.