CMS Price Transparency Data

Total knee replacement

Facility: Monument Health Rapid City Hospital

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27447
  • Insurance Median: $35,378
  • Cash Discount Price: $57,870
  • vs. Medicare Baseline: 2.70x Medicare
The contracted insurance negotiated median rate for a Total knee replacement at Monument Health Rapid City Hospital is $35,378. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $57,870. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 2.70x the Medicare baseline. Located in 353 Fairmont Blvd, Rapid City, SD.
Cash / Self-Pay
$57,870

Average discount available for prompt cash payment at this facility.

Insurance Median
$35,378

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: $57,870 (441%)
Insurance Median: $35,378 (270%)
Cash: $57,870 (441% of Medicare)
Ins. Median: $35,378 (270% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 270% of the Medicare baseline (a markup of 170%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Blue Cross Blue Shield $13,431 - $25,750 102%
Healthpartners [3081368] $13,431 102%
Humana $13,431 - $52,083 102%
Medicare (plans) $13,431 102%
Tricare $13,431 102%
UnitedHealthcare $13,431 - $35,378 102%
Va Black Hills Health Care System 12115 [3081206] $13,431 102%
Minnesota Health Care Programs 12K16 [3081295] $17,535 134%
Risk Admin Svs [3081167] $29,747 227%
Health Partners Sx009 [3081102] $33,786 258%
Govt Employees Health Assn [3081090] $35,378 270%
National Telephone Cooperative Assn 52103 [3081149] $35,378 270%
Surest [3081369] $35,378 270%
United Medical Resources 39026 [3081194] $35,378 270%
Coresource 38225 [3081146] $37,616 287%
Avera Health Plans 46045 [3081018] $40,293 307%
Rocky Mountain Admin Llc 83028 [3081168] $46,296 353%
Group And Pension Administrators Inc [3081098] $48,030 366%
Multiplan Inc 34080 [3081285] $48,030 366%
Medica (Commercial) 94265 [3081118] $48,032 366%
Employee Benefit Management 12X44 [3081079] $49,190 375%
Pacificsource Health Plans [3081333] $49,190 375%
Sanford Health Plan 91184 [3081174] $49,383 376%
Aetna $52,083 397%
Allied Benefit Systems Inc [3081320] $54,265 414%
Cigna $54,265 414%
Key Benefit Administrators [3081332] $54,265 414%
Meritain Health [3081135] $54,265 414%
Midlands Choice 47080 [3081136] $54,265 414%
Preferred One 41147 [3081160] $54,265 414%
Tlc Advantage Llc [3081189] $54,398 415%
Fedmed Inc [3081283] $54,977 419%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 353 Fairmont Blvd, Rapid City, SD 57701
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals