CMS Price Transparency Data

Total knee replacement

Facility: Tri Valley Health System

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27447
  • Insurance Median: $1,444
  • Cash Discount Price: $2,954
  • vs. Medicare Baseline: 0.11x Medicare
The contracted insurance negotiated median rate for a Total knee replacement at Tri Valley Health System is $1,444. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,954. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.11x the Medicare baseline. Located in 1305 West Highway 6/34, Cambridge, NE.
Cash / Self-Pay
$2,954

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,444

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: $2,954 (23%)
Insurance Median: $1,444 (11%)
Cash: $2,954 (23% of Medicare)
Ins. Median: $1,444 (11% 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.

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
Blue Cross Blue Shield $329 - $3,118 3%
Humana $329 - $1,444 3%
Medica Mcr Adv $329 - $1,444 3%
Medica Prime Sol $329 - $1,444 3%
Tricare $329 - $1,444 3%
Wellcare Mcr Adv - All Plans $329 - $1,444 3%
Great Plains Mcr Adv - All Plans $345 - $1,516 3%
Healthy Blue Mcaid - All Plans $453 - $2,346 3%
Molina Mcaid - All Plans $453 - $2,346 3%
Nebraska Total Care-All Plans $453 - $2,370 3%
UnitedHealthcare $453 - $3,151 3%
Amerigroup Mcaid - All Plans $462 - $2,393 4%
Medica Chi Aco - All Other Plans $850 - $2,954 6%
Medica Chi Open Access $850 - $2,954 6%
Medica Ifb Aco $850 - $2,954 6%
Medica Ifb Open Access $850 - $2,954 6%
Midlands Choice-All Plans $850 - $2,954 6%
Aetna $925 - $3,216 7%
Multiplan-All Plans $925 - $3,379 7%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1305 West Highway 6/34, Cambridge, NE 69022
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals