CMS Price Transparency Data

Total knee replacement

Facility: Harlan County Health System

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $3,128
Cash Discount Price: $2,820
vs. Medicare Baseline: 0.24x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at Harlan County Health System is $3,128. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,820. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.24x the Medicare baseline. Located in 717 Brown St, Alma, NE.

Cash / Self-Pay

$2,820

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,128

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: $2,820 (21%)

Insurance Median: $3,128 (24%)

Cash: $2,820 (21% of Medicare)

Ins. Median: $3,128 (24% 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
Aetna	$1,046 - $9,188	8%
Medica Chi Health	$1,046 - $11,944	8%
Medica Mcr Adv	$1,046 - $7,088	8%
Medica Prime Solution	$1,046 - $7,088	8%
Tricare	$1,046 - $8,794	8%
UnitedHealthcare	$1,046 - $12,600	8%
Great Plains Mcr Adv-All Plans	$1,098 - $9,233	8%
Medica Ifb Aco	$1,897 - $12,600	14%
Blue Cross Blue Shield	$1,998 - $12,600	15%
Medica Chi Aco - All Other Plans	$1,998 - $11,944	15%
Medica Choice	$2,092 - $11,944	16%
Medica Ifb Open Access	$2,424 - $12,600	18%
Phcs/Multiplan-All Plans	$3,128 - $12,862	24%
Ohara Llc Wc- All Plans	$3,349 - $12,469	26%
Ambetter / Centene	$3,596	27%
Healthy Blue Mcaid-All Plans	$3,701	28%
Humana	$8,794	67%

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 $2,820.
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 Harlan County Health System 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.