CMS Price Transparency Data

Total knee replacement

Facility: The Children's Mercy Hospital

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $2,533
Cash Discount Price: $1,886
vs. Medicare Baseline: 0.19x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at The Children's Mercy Hospital is $2,533. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,886. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.19x the Medicare baseline. Located in 2401 Gillham Road, Kansas City, MO.

Cash / Self-Pay

$1,886

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,533

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: $1,886 (14%)

Insurance Median: $2,533 (19%)

Cash: $1,886 (14% of Medicare)

Ins. Median: $2,533 (19% 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	$1,214 - $2,589	9%
Healthy Blue	$1,295 - $1,810	10%
Medicaid / KanCare	$1,307	10%
Wppa Providrs Care	$1,492	11%
Healthlink	$1,667	13%
Health Midwest Comprehensive Care	$1,708	13%
Home State Health	$1,810	14%
American Healthcare Alliance	$1,823	14%
Quiktrip	$2,032	15%
Blue Cross Blue Shield	$2,071 - $2,682	16%
Medica	$2,291	17%
Wellfit/Centrus	$2,362	18%
Centivo	$2,433	19%
Humana	$2,525	19%
Orscheln	$2,552	19%
Nebraska Furniture Mart	$2,570	20%
Aetna	$2,590 - $3,060	20%
Multiplan	$2,669	20%
Mercy Health	$2,868	22%
Coxhealth Network	$2,907	22%
Cigna	$3,129	24%
Coventry Health Care Of Kansas	$3,274	25%
National Preferred Provider Network	$3,458	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 $1,886.
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 The Children's Mercy 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.