CMS Price Transparency Data

Total knee replacement

Facility: Schuylkill Medical Center - South Jackson Street

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27447
  • Insurance Median: $13,471
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.03x Medicare
The contracted insurance negotiated median rate for a Total knee replacement at Schuylkill Medical Center - South Jackson Street is $13,471. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 1.03x the Medicare baseline. Located in 420 South Jackson Street, Pottsville, PA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$13,471

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%)
Insurance Median: $13,471 (103%)
Ins. Median: $13,471 (103% 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
Aetna $885 - $70,482 7%
Amerihealth Caritas $892 7%
UnitedHealthcare $916 - $13,217 7%
Geisinger $923 - $30,928 7%
Highmark Wholecare/Gateway $986 8%
Jefferson Health Partners $1,048 - $25,417 8%
Pa Health & Wellness $1,048 8%
Upmc $1,277 - $61,891 10%
Blue Cross Blue Shield $12,709 - $20,838 97%
Highmark Blue Shield $12,963 - $40,184 99%
Amerihealth $13,090 100%
Cigna $13,090 100%
Devoted Health $13,471 103%
Humana $13,471 103%
Gateway $13,598 104%
Emblem $13,725 - $56,680 105%
Pa Health & Wellness (Allwell) $13,979 107%
Ambetter / Centene $38,545 294%
Valley Preferred $74,110 565%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 420 South Jackson Street, Pottsville, PA 17901
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals