CMS Price Transparency Data

Total knee replacement

Facility: SSM Health St Anthony Hospital - Oklahoma City

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27447
  • Insurance Median: $16,457
  • Cash Discount Price: $15,465
  • vs. Medicare Baseline: 1.25x Medicare
The contracted insurance negotiated median rate for a Total knee replacement at SSM Health St Anthony Hospital - Oklahoma City is $16,457. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $15,465. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 1.25x the Medicare baseline. Located in 1000 North Lee Avenue, Oklahoma City, OK.
Cash / Self-Pay
$15,465

Average discount available for prompt cash payment at this facility.

Insurance Median
$16,457

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: $15,465 (118%)
Insurance Median: $16,457 (125%)
Cash: $15,465 (118% of Medicare)
Ins. Median: $16,457 (125% 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
Medica $1,946 - $11,491 15%
Oscar $4,387 - $16,244 33%
Blue Cross Blue Shield $12,348 - $12,718 94%
UnitedHealthcare $12,531 - $19,664 96%
Humana $12,558 96%
Ambetter / Centene $16,670 127%
Community Care $22,844 - $30,870 174%
Healthchoice $23,160 177%
Kempton $24,078 184%
Global Health $26,424 - $27,042 201%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 North Lee Avenue, Oklahoma City, OK 73101
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals