CMS Price Transparency Data

Total knee replacement

Facility: Metrohealth System

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27447
  • Insurance Median: $14,576
  • Cash Discount Price: $3,270
  • vs. Medicare Baseline: 1.11x Medicare
The contracted insurance negotiated median rate for a Total knee replacement at Metrohealth System is $14,576. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,270. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 1.11x the Medicare baseline. Located in 2500 Metrohealth Drive, Cleveland, OH.
Cash / Self-Pay
$3,270

Average discount available for prompt cash payment at this facility.

Insurance Median
$14,576

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: $3,270 (25%)
Insurance Median: $14,576 (111%)
Cash: $3,270 (25% of Medicare)
Ins. Median: $14,576 (111% 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
Aetna $3,019 - $19,434 23%
Cigna $5,081 39%
Medical Mutual $6,612 - $48,304 50%
UnitedHealthcare $8,521 65%
Aarp $12,146 93%
Valor Health $12,268 94%
Perennial Advantage $12,389 94%
Mcgregor Pace $13,361 102%
Buckeye Health Plan $15,790 120%
Caresource $17,005 130%
Health E Ohio $25,507 194%
Blue Cross Blue Shield $26,417 - $46,309 201%
Clarity Health $31,581 241%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2500 Metrohealth Drive, Cleveland, OH 44109
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals