CMS Price Transparency Data

Total knee replacement

Facility: Hackensack University Medical Center

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $12,227
Cash Discount Price: $15,153
vs. Medicare Baseline: 0.93x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at Hackensack University Medical Center is $12,227. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $15,153. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.93x the Medicare baseline. Located in 30 Prospect Ave, Hackensack, NJ.

Cash / Self-Pay

$15,153

Average discount available for prompt cash payment at this facility.

Insurance Median

$12,227

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: $15,153 (116%)

Insurance Median: $12,227 (93%)

Cash: $15,153 (116% of Medicare)

Ins. Median: $12,227 (93% 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
Clover	$2,611	20%
Horizon	$2,728 - $16,802	21%
Karna	$2,742	21%
UnitedHealthcare	$3,192 - $30,778	24%
Lhp Health	$3,548	27%
Aetna	$3,642 - $15,220	28%
Seoul Medical Group	$4,149	32%
Chn	$7,058	54%
Qualcare	$7,712 - $12,912	59%
Amerihealth	$8,013 - $8,904	61%
Activecare First McO	$8,539	65%
Intergroup	$10,156	77%
Bergen Risk	$10,881	83%
Cigna	$11,606 - $21,225	88%
Multiplan - PHCS	$12,332	94%
Brighton Health Plan	$13,057	100%
Blue Cross Blue Shield	$15,153	116%
Vaccn	$15,153	116%
Wellcare	$15,153	116%
United Community/Americhoice	$15,910	121%
Oxford	$25,336	193%

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 $15,153.
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 Hackensack University Medical Center 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.