CMS Price Transparency Data

Total knee replacement

Facility: Lehigh Valley Hospital - Macungie

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27447
  • Insurance Median: $14,017
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.07x Medicare
The contracted insurance negotiated median rate for a Total knee replacement at Lehigh Valley Hospital - Macungie is $14,017. 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 1.07x the Medicare baseline. Located in 3369 State Route 100, Macungie, PA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$14,017

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: $14,017 (107%)
Ins. Median: $14,017 (107% 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
Geisinger $970 - $57,577 7%
Highmark Wholecare/Gateway $986 8%
Jefferson Health Partners $1,048 - $26,200 8%
Pa Health & Wellness $1,048 8%
Aetna $1,125 - $65,395 9%
Amerihealth Caritas $1,125 9%
Upmc $1,277 - $63,797 10%
Blue Cross Blue Shield $13,100 100%
Highmark Blue Shield $13,231 - $35,221 101%
Humana $13,231 101%
Amerihealth $13,493 103%
Cigna $13,493 103%
Gateway $14,017 107%
Emblem $14,148 - $58,426 108%
Pa Health & Wellness (Allwell) $14,410 110%
Ambetter / Centene $39,732 303%
Valley Preferred $76,392 582%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3369 State Route 100, Macungie, PA 18062
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals