CMS Price Transparency Data

Total knee replacement

Facility: Sunrise Hospital and Medical Center

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $1,650
Cash Discount Price: $4,528
vs. Medicare Baseline: 0.13x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at Sunrise Hospital and Medical Center is $1,650. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,528. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.13x the Medicare baseline. Located in 3186 S Maryland Pkwy, Las Vegas, NV.

Cash / Self-Pay

$4,528

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,650

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: $4,528 (35%)

Insurance Median: $1,650 (13%)

Cash: $4,528 (35% of Medicare)

Ins. Median: $1,650 (13% 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
Amerigroup	$848 - $1,571	6%
Health Plan Nevada	$848 - $1,650	6%
Molina	$891 - $1,732	7%
Silver Summit	$891 - $1,732	7%
Humana	$919 - $14,000	7%
Healthcare Partners Of Nv	$1,213 - $1,642	9%
Aetna	$1,238 - $3,959	9%
Alignment Health Plan	$1,238	9%
Blue Cross Blue Shield	$1,238 - $24,082	9%
United	$1,263 - $27,118	10%
Community Care Health	$1,294	10%
Molina Healthcare	$1,294 - $1,346	10%
Sierra Hpn	$1,294	10%
Caremore	$1,299	10%
Caresource	$1,346	10%
Hometown Health Providers	$1,423 - $21,916	11%
Culinary Health Fund	$1,544 - $3,073	12%
Sierra	$1,626 - $19,125	12%
Cigna	$1,640 - $6,461	13%
Multiplan	$1,642	13%
Select Health	$2,494 - $14,000	19%
Ambetter / Centene	$2,626	20%
Health Services Coalition	$4,096 - $10,604	31%
Legacy Provider Network	$9,446	72%
Corvel	$9,971	76%
Comp-Med Workers Comp	$10,181	78%
Olympus Medsave Usa	$10,496	80%

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 $4,528.
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 Sunrise Hospital and 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.