CMS Price Transparency Data

Total knee replacement

Facility: Astera Health

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $2,107
Cash Discount Price: $2,755
vs. Medicare Baseline: 0.16x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at Astera Health is $2,107. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,755. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.16x the Medicare baseline. Located in 421 11Th Street Nw, Wadena, MN.

Cash / Self-Pay

$2,755

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,107

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: $2,755 (21%)

Insurance Median: $2,107 (16%)

Cash: $2,755 (21% of Medicare)

Ins. Median: $2,107 (16% 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
Sanford Health Plan [10120]	$452 - $1,180	3%
Blue Plus Pmap [40002]	$743 - $1,180	6%
Ucare Pmap [30006]	$883 - $21,512	7%
Health Partners Pmap [10046]	$911 - $29,727	7%
Medica Pmap [10057]	$911 - $22,044	7%
Primewest Pmap [30003]	$911 - $22,044	7%
Blue Cross Blue Shield	$1,180 - $44,946	9%
Health Partners [10045]	$1,180 - $42,257	9%
Medica Nonpmap [10056]	$1,180 - $297,238	9%
Primewest Non Pmap [30004]	$1,180	9%
Ucare Non Pmap [30007]	$1,180 - $24,822	9%
UnitedHealthcare	$1,711 - $45,684	13%
Ucare Commercial [10705]	$2,837 - $43,935	22%
Multiplan	$3,052 - $47,280	23%
Aetna	$3,434 - $53,190	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 $2,755.
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 Astera Health 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.