CMS Price Transparency Data

Total knee replacement

Facility: Northeast Regional Medical Center

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $25,479
Cash Discount Price: $33,575
vs. Medicare Baseline: 1.94x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at Northeast Regional Medical Center is $25,479. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $33,575. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 1.94x the Medicare baseline. Located in 315 S Osteopathy, Kirksville, MO.

Cash / Self-Pay

$33,575

Average discount available for prompt cash payment at this facility.

Insurance Median

$25,479

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: $33,575 (256%)

Insurance Median: $25,479 (194%)

Cash: $33,575 (256% of Medicare)

Ins. Median: $25,479 (194% 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
Veterans Eval Services	$1,184	9%
Healthlink	$2,500 - $3,000	19%
Medicaid / KanCare	$10,969 - $17,879	84%
Medicare (plans)	$13,532	103%
Node Hospice Non Par Agree	$13,772	105%
Node Va	$13,772	105%
UnitedHealthcare	$13,772 - $104,923	105%
Blue Cross Blue Shield	$13,802 - $42,669	105%
Node Devoted Health Mcr Adv	$14,208	108%
Blue Pathway/Pathway X	$15,574	119%
Centurion Correctional	$17,216	131%
Us Department Of Labor	$17,216	131%
Home State Exchange	$24,790	189%
Naphcare	$26,168	200%
Immergrun	$27,545	210%
Blue Prefrerred	$32,601	249%
Self Pay	$33,575	256%
Blue Access	$33,579	256%
Cigna	$47,565 - $54,700	363%
Aetna	$52,042 - $116,675	397%
Access Health Services, Llc	$90,933	693%
Multiplan	$104,923 - $111,918	800%
Coventry Wc	$111,918	853%

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 $33,575.
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 Northeast Regional Medical Center 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.