CMS Price Transparency Data

Total knee replacement

Facility: Cincinnati Children's Hospital Medical Center

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27447
  • Insurance Median: $6,257
  • Cash Discount Price: $5,207
  • vs. Medicare Baseline: 0.48x Medicare
The contracted insurance negotiated median rate for a Total knee replacement at Cincinnati Children's Hospital Medical Center is $6,257. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,207. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.48x the Medicare baseline. Located in 3333 Burnet Avenue, Cincinnati, OH.
Cash / Self-Pay
$5,207

Average discount available for prompt cash payment at this facility.

Insurance Median
$6,257

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: $5,207 (40%)
Insurance Median: $6,257 (48%)
Cash: $5,207 (40% of Medicare)
Ins. Median: $6,257 (48% 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
Blue Cross Blue Shield $865 - $9,019 7%
Caresource_In $908 - $1,210 7%
Aetna $1,030 - $10,210 8%
Humana $1,082 - $1,443 8%
Wellcare_Ky $1,082 - $1,443 8%
United_Health_Care_Ky $1,087 - $1,450 8%
Caresource_Oh $1,096 - $1,289 8%
Amerihealth_Caritas_Oh $1,127 - $1,326 9%
Molina_Oh $1,148 - $1,351 9%
Buckeye_Oh $1,200 - $1,412 9%
United_Health_Care_Oh $1,305 - $1,535 10%
Passport_Ky $1,429 11%
United_Health_Care_Insurance $4,194 - $8,184 32%
Caresource_Oh_Insurance $5,105 39%
Medical_Mutual_Of_Ohio_Insurance $5,467 - $9,291 42%
Parkview_Signature_Care_Insurance $6,257 - $7,361 48%
Point_Comfort_Insurance $6,636 51%
Margaret_Mary_Health_Insurance $6,769 - $7,964 52%
Cigna $6,943 - $8,168 53%
Health_Ohio_Network_Insurance $8,168 - $9,700 62%
Beechstreet_Insurance $8,245 - $9,700 63%
Evolutions_Health_Care_Systems $9,189 70%
Galaxy_Health_Insurance $9,189 70%
Private_Health_Care_Systems_Insurance $9,507 72%
Custom_Design_Benefits_Insurance $9,700 74%
First_Health_Group_Insurance $9,700 74%
Health_Link_Insurance $9,700 74%
Health_Smart_Preferred_Insurance $9,700 74%
Medical_Benefit_Administrators_Insurance $9,700 74%
Ohio_Health_Choice_Insurance $9,700 74%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3333 Burnet Avenue, Cincinnati, OH 45229
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens