CMS Price Transparency Data

Total knee replacement

Facility: The Nebraska Methodist Hospital

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $13,100
Cash Discount Price: $3,825
vs. Medicare Baseline: 1.00x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at The Nebraska Methodist Hospital is $13,100. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,825. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 1.00x the Medicare baseline. Located in 8303 Dodge St, Omaha, NE.

Cash / Self-Pay

$3,825

Average discount available for prompt cash payment at this facility.

Insurance Median

$13,100

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: $3,825 (29%)

Insurance Median: $13,100 (100%)

Cash: $3,825 (29% of Medicare)

Ins. Median: $13,100 (100% 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
Ne Furniture Mart	$4,887	37%
Wellmark	$5,312 - $24,610	40%
Midlands Choice	$7,437	57%
Aetna	$10,255 - $12,911	78%
Humana	$12,911	98%
Medicare (plans)	$12,911 - $13,169	98%
Blue Cross Blue Shield	$13,100 - $19,121	100%
Medica	$13,100 - $16,112	100%
UnitedHealthcare	$13,100 - $16,122	100%
Medica Choice	$18,955	145%
Elite Choice	$27,196	207%
Ambetter / Centene	$27,197	207%

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 $3,825.
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 Nebraska Methodist 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.