CMS Price Transparency Data

Total knee replacement

Facility: McKenzie County Healthcare Systems Inc

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $43,137
Cash Discount Price: $30,644
vs. Medicare Baseline: 3.29x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at McKenzie County Healthcare Systems Inc is $43,137. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $30,644. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 3.29x the Medicare baseline. Located in 709 4Th Ave Ne, Watford City, ND.

Cash / Self-Pay

$30,644

Average discount available for prompt cash payment at this facility.

Insurance Median

$43,137

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: $30,644 (234%)

Insurance Median: $43,137 (329%)

Cash: $30,644 (234% of Medicare)

Ins. Median: $43,137 (329% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 329% of the Medicare baseline (a markup of 229%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Humana	$22,629	173%
Sanford Health Plan	$22,629 - $45,730	173%
Blue Cross Blue Shield	$23,082 - $31,681	176%
Medica	$28,758 - $46,201	219%
First Choice Plus	$41,487	316%
UnitedHealthcare	$44,787 - $46,201	341%

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 $30,644.
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 McKenzie County Healthcare Systems Inc 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.