CMS Price Transparency Data

Total knee replacement

Facility: St Luke's Sugar Land Hospital

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $12,888
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.98x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at St Luke's Sugar Land Hospital is $12,888. 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 0.98x the Medicare baseline. Located in 1317 Lake Pointe Parkway, Sugar Land, TX.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$12,888

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: $12,888 (98%)

Ins. Median: $12,888 (98% 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
Aetna	$1,997 - $19,847	15%
Kelseycare	$2,405 - $17,398	18%
Cigna	$3,309 - $13,017	25%
Humana	$4,000 - $12,888	30%
United	$4,969 - $8,150	38%
Blue Cross Blue Shield	$8,926 - $22,849	68%
Renaissance	$9,279	71%
Kelsey	$9,953	76%
Selectcare	$12,888	98%
UnitedHealthcare	$13,145	100%
Amerivantage	$13,274	101%
Devoted	$13,790	105%
Scanhealth	$13,790	105%
Kindred	$14,176	108%
Community Health Choice	$19,331	147%
Superior Health Plan	$19,331	147%
Wellpoint	$19,331	147%
Bright Health	$20,621	157%
Nx Health	$41,885	319%

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 $X.
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 St Luke's Sugar Land Hospital 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.