CMS Price Transparency Data

Total knee replacement

Facility: Bay Area Hospital

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $2,987
Cash Discount Price: $3,694
vs. Medicare Baseline: 0.23x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at Bay Area Hospital is $2,987. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,694. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.23x the Medicare baseline. Located in 1775 Thompson Road, Coos Bay, OR.

Cash / Self-Pay

$3,694

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,987

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: $3,694 (28%)

Insurance Median: $2,987 (23%)

Cash: $3,694 (28% of Medicare)

Ins. Median: $2,987 (23% 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
Healthnet Mcr Adv	$1,230	9%
Moda Hlth Mcr Adv	$1,230	9%
Southwest Oregon Ipa - All Plans	$1,543	12%
Blue Cross Blue Shield	$2,706	21%
Providence - All Other Plans	$2,741	21%
Providence Pebb	$2,741	21%
Nasomah Hlth Grp - All Plans	$2,955	23%
Moda Beacon - All Other Plans	$3,018	23%
Pacificsource - All Plans	$3,133	24%
Ods Ppo/Pos - All Plans	$3,211	24%
Moda Connexus/Synergy	$3,354	26%
Healthnet Comm- All Other Plans	$4,678	36%
Healthnet Mcaid	$4,925	38%
Prov Behav Hlth	$6,156	47%

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 $3,694.
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 Bay Area Hospital 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.