CMS Price Transparency Data

Total knee replacement

Facility: Mercy Medical Center

Billing Code: 27447 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$7,815

about 0.6× the $13,117 Medicare rate · typically $3,085–$15,195

modeled estimate · not a bill or quote

What this hospital charges insurers

$15,226

Well above the fair price

about $7,411 over the fair price · 1.2× Medicare

Medicare pays $13,117 Fair price $7,815 This hospital $15,226

How we calculate the fair BaseRate →

How this hospital compares to other NY hospitals

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

Cheapest $2,599 Priciest $15,226

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

A fair price for a Total knee replacement is about $7,815 (about 0.6× the $13,117 Medicare rate). Mercy Medical Center charges insurers about $15,226 — well above the fair price. Located in Rockville Centre, NY.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $7,815. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser 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
UnitedHealthcaremajor	$4,127 - $21,811	31%
Blue Cross Blue Shieldmajor	$14,922 - $21,433	114%
Aetnamajor	$15,226	116%
Cignamajor	$37,126	283%
Humanamajor	$15,531	118%
AmeriHealth	$37,681	287%
Cigna HealthSpring	$15,226	116%
Fidelis Care	$4,127 - $15,226	31%
Independent Health	$4,127 - $15,226	31%
MVP Health Care	$4,127 - $37,126	31%
WellCare	$16,749	128%
+ 31 smaller / regional plans	$2,250 - $46,247

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

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, 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 Mercy 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 Mercy Medical Center

Compare: Total knee replacement at other NY hospitals

Brooks-Tlc Hospital System, Inc · Dunkirk $2,599
Nassau University Medical Center · East Meadow $2,954
Arnot Ogden Medical Center · Elmira $3,804
Metropolitan Hospital Center · New York $4,237
Harlem Hospital Center · New York $4,254
Jacobi Medical Center · Bronx $4,265
South Brooklyn Health · Brooklyn $4,323
Memorial Hospital for Cancer and Allied Diseases · New York $4,587

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