CMS Price Transparency Data

Total knee replacement

Facility: Highpoint Health-Sumner With Ascension Saint Thoma

Billing Code: 27447 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$12,493

about 1.0× the $13,117 Medicare rate · typically $2,964–$21,677

modeled estimate · not a bill or quote

What this hospital charges insurers

$3,055

Below the fair price — a good deal

about $9,438 under the fair price · 0.2× Medicare

Medicare pays $13,117 Fair price $12,493 This hospital $3,055 Cash price $18,465 Hospital's list price $79,249

How we calculate the fair BaseRate →

How this hospital compares to other TN hospitals

Lowest price of the 9 TN hospitals we have prices for — a strong deal.

Cheapest $3,055 Priciest $8,787

Black dot = this hospital, among the 9 TN hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Total knee replacement is about $12,493 (about 1.0× the $13,117 Medicare rate). Highpoint Health-Sumner With Ascension Saint Thoma charges insurers about $3,055, or about $18,465 in cash — below the fair price — a good deal. Located in Gallatin, TN.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

2 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield AetnaCignaHumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$13,197	101%
Blue Cross Blue Shieldmajor	$2,813 - $3,055	21%

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 18,465), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 27447.

Insurance Before you use insurance

Call your insurance company to confirm Highpoint Health-Sumner With Ascension Saint Thoma is in-network.
Ask your insurer whether prior approval is required for CPT code 27447.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Highpoint Health-Sumner With Ascension Saint Thoma

Compare: Total knee replacement at other TN hospitals

Insurance negotiated median for the same procedure, sorted lowest first.