CMS Price Transparency Data

Total knee replacement

Facility: Elmhurst Hospital Center

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27447
  • Insurance Median: $5,195
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.40x Medicare
The contracted insurance negotiated median rate for a Total knee replacement at Elmhurst Hospital Center is $5,195. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.40x the Medicare baseline. Located in 79-01 Broadway, Elmhurst, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$5,195

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%)
Insurance Median: $5,195 (40%)
Ins. Median: $5,195 (40% 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
United $957 - $5,195 7%
Healthfirst $1,164 - $9,350 9%
Amidacare $1,455 11%
Emblem $1,455 - $22,839 11%
Wellcare $1,571 12%
Metroplus $1,869 - $4,156 14%
Fidelis $2,095 - $21,621 16%
Blue Cross Blue Shield $4,156 - $15,226 32%
Carelon $4,156 32%
United Behavioral Health $4,156 - $4,571 32%
Affinity $4,239 - $9,350 32%
Carelon (Amida Care) $4,239 32%
Vnsny $4,239 - $15,226 32%
Senior Whole Health $15,220 116%
Aetna $15,226 116%
Vaccn $15,226 116%
Centers Plan For Healthy Living $15,835 121%
Oscar $22,839 174%
Elderplan $30,452 232%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 79-01 Broadway, Elmhurst, NY 11373
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals