CMS Price Transparency Data

Total knee replacement

Facility: Avita Ontario

Billing Code: 27447 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$11,865

about 0.9× the $13,117 Medicare rate · typically $9,849–$11,865

modeled estimate · not a bill or quote

Medicare pays $13,117 Fair price $11,865 Cash price $82,952 Hospital's list price $97,591

How we calculate the fair BaseRate →

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	$1,545 - $70,510	12%
Blue Cross Blue Shieldmajor	$1,545 - $69,582	12%
Aetnamajor	$13,117 - $97,591	100%
Cignamajor	$76,023	580%
Humanamajor	$1,545 - $13,117	12%
AmeriHealth	$2,638	20%
CareSource	$1,545	12%
Medical Mutual	$13,117 - $78,073	100%
Molina	$1,545 - $13,117	12%
+ 2 smaller / regional plans	$1,545 - $13,117

Government programs also on file: Medicare, Medicaid.

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 (about 82,952), 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 Avita Ontario 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 Avita Ontario

Compare: Total knee replacement at other OH hospitals

Henry County Hospital, Inc · Napoleon $3,045
Akron General Medical Center · Akron $3,277
Cleveland Clinic · Cleveland $3,898
Nationwide Children's Hospital · Columbus $4,313
Adena Pike Medical Center · Waverly $6,905
Berger Hospital · Circleville $7,833
Bellevue Hospital · Bellevue $10,128
Lodi Community Hospital · Lodi $10,169

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