CMS Price Transparency Data

Total knee replacement

Facility: Overlook Medical Center

Billing Code: 27447 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$14,477

about 1.1× the $13,117 Medicare rate · typically $6,761–$21,624

modeled estimate · not a bill or quote

What this hospital charges insurers

$14,971

About the fair price

about $494 over the fair price · 1.1× Medicare

Medicare pays $13,117 Fair price $14,477 This hospital $14,971 Cash price $17,640 Hospital's list price $67,381

How we calculate the fair BaseRate →

How this hospital compares to other NJ hospitals

Highest price of the 9 NJ hospitals we have prices for — worth calling around.

Cheapest $2,674 Priciest $14,971

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

A fair price for a Total knee replacement is about $14,477 (about 1.1× the $13,117 Medicare rate). Overlook Medical Center charges insurers about $14,971, or about $17,640 in cash — about the fair price. Located in Summit, NJ.

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

✓ Blue Cross Blue Shield✓ Aetna✓ Cigna UnitedHealthcareHumanaKaiser 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
Blue Cross Blue Shieldmajor	$14,387 - $15,638	110%
Aetnamajor	$14,930 - $22,063	114%
Cignamajor	$14,930	114%
Ambetter (Centene)	$14,930	114%
AmeriHealth	$14,930 - $18,064	114%
Health Net	$22,063	168%
UPMC Health Plan	$14,930	114%
WellCare	$14,930	114%
+ 23 smaller / regional plans	$2,586 - $22,063

Government programs also on file: Medicare, Medicaid, Military & VA.

Excludes 5 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 17,640), 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 Overlook Medical Center 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 Overlook Medical Center

Compare: Total knee replacement at other NJ hospitals

St Joseph's University Medical Center Inc · Paterson $2,674
Raritan Bay Medical Center · Perth Amboy $9,176
Jefferson Stratford Hospital · Stratford $10,746
Ocean Medical Center · Brick $12,867
Jfk University Medical Center · Edison $12,867
Cape Regional Medical Center Inc · Cape May Court House $14,002
Capital Health Regional Medical Center · Trenton $14,062
Southern Ocean Medical Center · Manahawkin $14,062

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