CMS Price Transparency Data

Total knee replacement

Facility: Cherry County Hospital

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $2,707
Cash Discount Price: $5,685
vs. Medicare Baseline: 0.21x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at Cherry County Hospital is $2,707. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,685. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.21x the Medicare baseline. Located in 510 North Green St, Valentine, NE.

Cash / Self-Pay

$5,685

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,707

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: $5,685 (43%)

Insurance Median: $2,707 (21%)

Cash: $5,685 (43% of Medicare)

Ins. Median: $2,707 (21% 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
Molina Mcr Adv	$1,098	8%
Avera Hmo	$1,478	11%
Ambetter / Centene	$1,690	13%
Midwest Ntwrk Profee Only - All Plans	$2,092	16%
Oscar Profee Only - All Plans	$2,092	16%
Molina Mcaid - All Other Plans	$2,393	18%
Avera Aca Ppo	$2,454	19%
Midlands Choice-All Plans	$2,588	20%
Avera Aso Ppo	$2,599	20%
Avera Non-Aca Ppo - All Other Plans	$2,707	21%
UnitedHealthcare	$3,118	24%
First Choice-All Plans	$5,295 - $5,734	40%
Multiplan-All Plans	$5,295 - $5,734	40%
Phcs-All Plans	$5,295 - $5,734	40%
Tlc Advantage-All Plans	$5,295 - $5,734	40%

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 $5,685.
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 Cherry County 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.