CMS Price Transparency Data

Total knee replacement

Facility: CHI Health St. Marys

Billing Code: 27447 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$2,155

about 0.2× the $13,117 Medicare rate · typically $1,185–$4,600

modeled estimate · not a bill or quote

What this hospital charges insurers

$3,348

Above the fair price

about $1,193 over the fair price · 0.3× Medicare

Medicare pays $13,117 Fair price $2,155 This hospital $3,348 Cash price $2,895 Hospital's list price $3,488

How we calculate the fair BaseRate →

How this hospital compares to other NE hospitals

A typical price — 3 charge more and 3 charge less, among the 9 NE hospitals compared.

Cheapest $2,393 Priciest $12,539

Black dot = this hospital, among the 9 NE hospitals with a price for this procedure. Full list below.

A fair price for a Total knee replacement is about $2,155 (about 0.2× the $13,117 Medicare rate). CHI Health St. Marys charges insurers about $3,348, or about $2,895 in cash — above the fair price. Located in Nebraska City, NE.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $2,155. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

3 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Humana AetnaCignaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$1,395 - $3,348	11%
Blue Cross Blue Shieldmajor	$1,395 - $3,314	11%
Humanamajor	$1,395	11%
Ambetter (Centene)	$1,423 - $1,430	11%
Amerigroup	$747 - $1,465	6%
Medica	$1,395 - $3,348	11%
Molina	$762	6%
+ 7 smaller / regional plans	$1,395 - $3,348

Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 2,895), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 27447.

Insurance Before you use insurance

Call your insurance company to confirm CHI Health St. Marys is in-network.
Ask your insurer whether prior approval is required for CPT code 27447.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at CHI Health St. Marys

Compare: Total knee replacement at other NE hospitals

Cherry County Hospital · Valentine $2,393
The Nebraska Medical Center · Omaha $2,459
Regional West Medical Center · Scottsbluff $2,512
CHI Health Schuyler · Schuyler $3,348
CHI Health Plainview Hospital · Plainview $3,348
CHI Health St. Elizabeth · Lincoln $12,418
CHI Health Nebraska Heart · Lincoln $12,418
CHI Health Bergan Mercy · Omaha $12,539

Insurance negotiated median for the same procedure, sorted lowest first.