CMS Price Transparency Data

Total knee replacement

Facility: Union Hospital

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $2,988
Cash Discount Price: $4,587
vs. Medicare Baseline: 0.23x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at Union Hospital is $2,988. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,587. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.23x the Medicare baseline. Located in 659 Boulevard, Dover, OH.

Cash / Self-Pay

$4,587

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,988

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: $4,587 (35%)

Insurance Median: $2,988 (23%)

Cash: $4,587 (35% of Medicare)

Ins. Median: $2,988 (23% 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
Summacare	$792 - $11,889	6%
Aetna	$1,218 - $11,889	9%
Blue Cross Blue Shield	$1,218 - $11,889	9%
Cigna	$1,218 - $12,245	9%
Humana	$1,218 - $11,889	9%
The Health Plan	$1,218	9%
United	$1,218 - $11,889	9%
Valor	$1,218 - $11,889	9%
Buckeye	$1,228 - $6,900	9%
Molina	$1,228 - $7,245	9%
Mmo	$1,254 - $12,245	10%
Aultcare	$1,279 - $10,105	10%
Communicare	$1,279 - $12,483	10%
Caresource	$1,289 - $6,900	10%
Perennial Health	$1,315 - $12,840	10%
Pphp	$1,315 - $13,078	10%
Zing Health	$1,340 - $13,078	10%
Amerihealth	$1,351 - $7,590	10%
Cc Ehp	$1,366 - $1,461	10%
Oscar	$1,884	14%
Ohcp	$2,745	21%
Omas	$3,528	27%
Healthsmart	$3,881	30%
Phphi	$4,234	32%
Upmc	$4,234 - $11,889	32%
Gms	$4,940	38%
Consociate Health	$5,293	40%
Multiplan	$6,351	48%
UnitedHealthcare	$11,381 - $11,889	87%
Devoted Health	$11,889	91%

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 $4,587.
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 Union Hospital 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.