CMS Price Transparency Data

Total knee replacement

Facility: Texas Scottish Rite Hospital for Children

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $5,153
Cash Discount Price: $5,153
vs. Medicare Baseline: 0.39x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at Texas Scottish Rite Hospital for Children is $5,153. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,153. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.39x the Medicare baseline. Located in 2222 Welborn Street, Dallas, TX.

Cash / Self-Pay

$5,153

Average discount available for prompt cash payment at this facility.

Insurance Median

$5,153

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: $5,153 (39%)

Insurance Median: $5,153 (39%)

Cash: $5,153 (39% of Medicare)

Ins. Median: $5,153 (39% 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
Tricare	$1,262	10%
Blue Cross Blue Shield	$1,436 - $5,153	11%
Aetna	$1,932 - $5,153	15%
Cigna	$2,424	18%
Firstcare Health Comm - All Other Plans	$3,607	27%
Healthscope - All Plans	$3,865	29%
Scott & White Comm- All Other Plans	$3,865	29%
UnitedHealthcare	$3,865 - $5,153	29%
Children Med Center Health Plan - All Plans	$5,153	39%
Community First Health Plan-All Plans	$5,153	39%
Cook Childrens Hp-All Plans	$5,153	39%
Driscoll Childrens-All Plans	$5,153	39%
Medicaid / KanCare	$5,153	39%
Molina Commercial - All Other Plans	$5,153	39%
Soonercare-All Plans	$5,153	39%
Firstcare Health Mcaid	$5,411	41%
Tx Childrens Hlth Mcaid-All Plans	$5,411	41%

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 $5,153.
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 Texas Scottish Rite Hospital for Children 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.