CMS Price Transparency Data

Total knee replacement

Facility: Adventist Health Tillamook

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $2,907
Cash Discount Price: $2,327
vs. Medicare Baseline: 0.22x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at Adventist Health Tillamook is $2,907. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,327. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.22x the Medicare baseline. Located in 1000 Third Street, Tillamook, OR.

Cash / Self-Pay

$2,327

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,907

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: $2,327 (18%)

Insurance Median: $2,907 (22%)

Cash: $2,327 (18% of Medicare)

Ins. Median: $2,907 (22% 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	$1,118 - $2,513	9%
Moda Health Plan - All Plans	$1,140	9%
Sterling Life - All Plans	$1,163	9%
Medicare (plans)	$1,174	9%
Devoted Health	$1,207	9%
Blue Cross Blue Shield	$1,286 - $5,747	10%
Hvhs Mcare - All Plans	$1,353	10%
Lifewise - All Plans	$1,771 - $5,958	14%
Ah Employee Health Plan - All Plans	$1,845 - $6,209	14%
First Choice Health- All Plans	$1,845 - $6,209	14%
Health Net - All Plans	$1,845 - $6,209	14%
Providence Preferred - All Plans	$1,924 - $6,473	15%
Workers Comp	$1,963 - $6,606	15%
UnitedHealthcare	$2,369	18%
Pacificsource - All Plans	$2,907	22%
Ods Health Plan - All Other Plans	$2,937	22%

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 $2,327.
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 Adventist Health Tillamook 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.