CMS Price Transparency Data

Total knee replacement

Facility: Penn State Health Hampden Medical Center

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $14,304
Cash Discount Price: $26,320
vs. Medicare Baseline: 1.09x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at Penn State Health Hampden Medical Center is $14,304. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $26,320. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 1.09x the Medicare baseline. Located in 2200 Good Hope Road, Enola, PA.

Cash / Self-Pay

$26,320

Average discount available for prompt cash payment at this facility.

Insurance Median

$14,304

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: $26,320 (201%)

Insurance Median: $14,304 (109%)

Cash: $26,320 (201% of Medicare)

Ins. Median: $14,304 (109% 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
[Amerihealth Caritas]	$10,666 - $12,548	81%
[Highmark Wholecare]	$10,666 - $12,548	81%
[Geisinger]	$11,293 - $55,817	86%
[Health Partners Plans]	$11,669 - $12,799	89%
[Pa Health & Wellness]	$11,732 - $12,924	89%
[Highmark]	$12,422 - $53,629	95%
UnitedHealthcare	$12,548 - $52,188	96%
[Cbc]	$12,548 - $41,775	96%
Aetna	$12,673 - $50,256	97%
Humana	$12,673	97%
[Healthspring]	$12,673	97%
[Upmc]	$12,799 - $61,789	98%
[Point Comfort Underwriters]	$15,685	120%
[Highmark Choice Blue]	$42,903	327%
[Highmark Aca]	$45,048	343%
Cigna	$51,309	391%
[Preferred Healthcare Systems]	$62,726	478%
[First Health]	$66,907	510%
[Multiplan]	$66,907	510%

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 $26,320.
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 Penn State Health Hampden Medical Center 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.