CMS Price Transparency Data

Total knee replacement

Facility: The University of Vermont Health Network - Champl

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $1,950
Cash Discount Price: $3,250
vs. Medicare Baseline: 0.15x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at The University of Vermont Health Network - Champl is $1,950. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,250. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.15x the Medicare baseline. Located in 75 Beekman Street, Plattsburgh, NY.

Cash / Self-Pay

$3,250

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,950

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: $3,250 (25%)

Insurance Median: $1,950 (15%)

Cash: $3,250 (25% of Medicare)

Ins. Median: $1,950 (15% 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
UnitedHealthcare	$839 - $15,721	6%
Mvp	$1,018 - $15,721	8%
Blue Cross Blue Shield	$1,153 - $74,657	9%
Aetna	$1,198 - $15,721	9%
Capital District Physicians' Health Plan	$1,198 - $15,721	9%
Fidelis Care	$1,198 - $15,721	9%
Humana	$1,198 - $14,935	9%
Martins Point	$1,198 - $16,837	9%
Veterans Affairs Community Care Network	$1,198 - $15,721	9%
Highmark Blueshield	$1,492 - $4,293	11%
Wellpath	$1,677 - $23,581	13%
Harvard Pilgrim	$2,600	20%
Magnacare	$2,600	20%
St. Regis	$2,600 - $15,721	20%
Coventry	$2,925	22%
Multiplan	$3,088	24%

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 $3,250.
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 The University of Vermont Health Network - Champl 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.