CMS Price Transparency Data

Total knee replacement

Facility: Mount Carmel Dublin

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $12,998
Cash Discount Price: $55,436
vs. Medicare Baseline: 0.99x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at Mount Carmel Dublin is $12,998. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $55,436. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.99x the Medicare baseline. Located in 4105 Emerald Pkwy, Dublin, OH.

Cash / Self-Pay

$55,436

Average discount available for prompt cash payment at this facility.

Insurance Median

$12,998

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: $55,436 (423%)

Insurance Median: $12,998 (99%)

Cash: $55,436 (423% of Medicare)

Ins. Median: $12,998 (99% 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
Aetna	$7,584 - $12,738	58%
Rural Carrier Health Benefit Plan	$7,584	58%
Medicare (plans)	$10,883 - $12,998	83%
Blue Cross Blue Shield	$12,132 - $38,411	92%
UnitedHealthcare	$12,374 - $42,111	94%
The Health Plan	$12,627	96%
Oscar	$20,426	156%
Enterprise Group Planning	$23,892	182%
Custom Design Benefits	$25,873	197%
Quality Care Partners	$27,977	213%
Medical Mutual	$30,421 - $41,938	232%
Western & Southern Financial Group	$41,938	320%
Geha	$42,111	321%

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 $55,436.
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 Mount Carmel Dublin 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.