CMS Price Transparency Data

Total knee replacement

Facility: Uva Health Culpeper Medical Center

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $12,881
Cash Discount Price: $27,679
vs. Medicare Baseline: 0.98x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at Uva Health Culpeper Medical Center is $12,881. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $27,679. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.98x the Medicare baseline. Located in 501 Sunset Lane, Culpeper, VA.

Cash / Self-Pay

$27,679

Average discount available for prompt cash payment at this facility.

Insurance Median

$12,881

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: $27,679 (211%)

Insurance Median: $12,881 (98%)

Cash: $27,679 (211% of Medicare)

Ins. Median: $12,881 (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
Champva [50002]	$1,274 - $1,300	10%
Tricare	$1,274 - $1,300	10%
Aetna	$2,016 - $13,416	15%
Cigna	$2,430 - $20,368	19%
UnitedHealthcare	$6,859 - $40,953	52%
Geha [40009]	$7,621 - $28,731	58%
Carefirst [30007]	$8,119 - $9,197	62%
Beacon Health Options [40012]	$10,365	79%
Commercial Contracted Hb Only [40056]	$10,883	83%
Commercial Generic [40000]	$10,883 - $14,511	83%
Blue Ridge Pace [10510]	$11,593	88%
Medicaid / KanCare	$11,593	88%
Commercial Contracted Tpa [40055]	$12,438 - $14,511	95%
Blue Cross Blue Shield	$12,881 - $38,467	98%
HMO Part B [10099]	$12,881	98%
Humana	$12,881 - $13,548	98%
Medicare (plans)	$12,881 - $13,283	98%
VA Ccn [99926]	$12,881 - $13,283	98%
VA Ccn [99927]	$12,881 - $13,283	98%
Veterans Administration [99910]	$13,283	101%
Umwa [40037]	$14,511	111%
Healthsmart [40013]	$15,548	119%
Multiplan Generic [40035]	$15,755 - $17,620	120%
Vhn Generic [40040]	$15,755 - $17,620	120%
First Health Generic [40033]	$16,999	130%
Gateway Health Alliance [40034]	$17,620	134%
Onenet Workers Comp Generic [60010]	$18,159	138%
Kaiser Permenente [40014]	$18,657	142%

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 $27,679.
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 Uva Health Culpeper Medical Center 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.