CMS Price Transparency Data

Total knee replacement

Facility: Jfk University Medical Center

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $10,702
Cash Discount Price: $13,560
vs. Medicare Baseline: 0.82x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at Jfk University Medical Center is $10,702. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $13,560. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.82x the Medicare baseline. Located in 65 James Street, Edison, NJ.

Cash / Self-Pay

$13,560

Average discount available for prompt cash payment at this facility.

Insurance Median

$10,702

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: $13,560 (103%)

Insurance Median: $10,702 (82%)

Cash: $13,560 (103% of Medicare)

Ins. Median: $10,702 (82% 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
Horizon	$1,314 - $14,254	10%
Aetna	$2,336 - $14,254	18%
UnitedHealthcare	$2,494 - $30,154	19%
Clover	$2,611	20%
Karna	$2,742	21%
Seoul Medical Group	$3,119	24%
Amerigroup	$3,801 - $14,254	29%
Qualcare	$9,170 - $9,342	70%
Intergroup	$10,156	77%
Activecare First McO	$10,156	77%
Brighton Health Plan	$10,163 - $22,178	77%
Amerihealth	$10,711 - $11,904	82%
Bergen Risk	$10,881	83%
Prime Health	$11,606	88%
Multiplan - PHCS	$12,332	94%
Vaccn	$12,867 - $14,254	98%
Wellcare	$12,867 - $14,254	98%
United Community/Americhoice	$13,510 - $14,967	103%
Blue Cross Blue Shield	$14,254	109%
Cigna	$20,323	155%
Oxford	$24,137	184%

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 $13,560.
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 Jfk 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.