CMS Price Transparency Data

Total knee replacement

Facility: Merit Health River Oaks

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27447
  • Insurance Median: $17,820
  • Cash Discount Price: $39,456
  • vs. Medicare Baseline: 1.36x Medicare
The contracted insurance negotiated median rate for a Total knee replacement at Merit Health River Oaks is $17,820. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $39,456. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 1.36x the Medicare baseline. Located in 1030 River Oaks Drive, Flowood, MS.
Cash / Self-Pay
$39,456

Average discount available for prompt cash payment at this facility.

Insurance Median
$17,820

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: $39,456 (301%)
Insurance Median: $17,820 (136%)
Cash: $39,456 (301% of Medicare)
Ins. Median: $17,820 (136% 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.

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 $1,155 9%
Ms Dept Of Rehabilitation Services $7,381 56%
Medicaid / KanCare $9,805 - $33,428 75%
UnitedHealthcare $9,805 - $58,527 75%
Magnolia Mcd Chip $9,903 75%
Caresource Truecare $10,001 76%
Molina Chip $10,589 81%
Humana $11,394 87%
Medicare (plans) $11,394 87%
Node First Choice Shared Health Of Ms Mcr Adv $11,394 87%
Node Vantage Health Mcr Adv $11,394 87%
Node Hospice Non Par Agree $11,592 88%
Node Va $11,592 88%
Molina $11,622 89%
Node Devoted Health Mcr Adv $11,622 89%
Node First Choice American Health Mcr Adv $11,622 89%
Aetna $11,736 - $153,442 89%
Node First Choice Wellcare Mcr Adv $11,823 90%
Node Healthy Mississippi Mcr Adv $12,751 97%
Node Us Dept Of Labor $14,489 110%
First Choice Preferred $17,387 133%
Node First Choice Occunet $17,387 133%
Blue Cross Blue Shield $17,650 135%
Advanced Health Systems $17,990 137%
Molina Exchange $19,349 148%
Node First Choice Seven Corners $19,706 150%
Magnolia Exchange $20,285 155%
Ms Work Comp $22,184 169%
Prime Health Wc $22,184 169%
First Choice Lgp $25,270 193%
Vantage Health Commercial $26,081 199%
Cigna $43,621 333%
Self Pay $48,224 368%
Trimed Billing Solutions $65,761 501%
Ms State Hospital Of Whitfield Ms $83,297 635%
First Choice Standard $100,833 769%
First Choice Coventry $113,985 869%
First Choice Mpcn Standard $120,561 919%
First Choice Ppo Plus $120,561 919%
Phcs $131,521 1003%
First Choice Stratose $175,362 1337%
Prime Health Services $175,362 1337%
American Health Group $186,322 1420%
Beech Street $186,322 1420%
Benefit Administration Services $186,322 1420%
Benefit Management Systems $186,322 1420%
Citizens State Bank Inc $186,322 1420%
Formost $186,322 1420%
Usa Mco $186,322 1420%
One Health Plan $197,282 1504%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1030 River Oaks Drive, Flowood, MS 39232
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals