CMS Price Transparency Data

Total knee replacement

Facility: Porter Hospital Inc

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27447
  • Insurance Median: $1,216
  • Cash Discount Price: $3,230
  • vs. Medicare Baseline: 0.09x Medicare
The contracted insurance negotiated median rate for a Total knee replacement at Porter Hospital Inc is $1,216. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,230. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.09x the Medicare baseline. Located in 115 Porter Drive, Middlebury, VT.
Cash / Self-Pay
$3,230

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,216

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: $3,230 (25%)
Insurance Median: $1,216 (9%)
Cash: $3,230 (25% of Medicare)
Ins. Median: $1,216 (9% 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.

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
Wellpath $355 - $1,776 3%
Coventry $420 - $1,550 3%
Blue Cross Blue Shield $499 - $17,148 4%
Medical Corporation $614 - $3,068 5%
Multiplan $614 - $3,068 5%
Veterans Affairs Community Care Network $646 - $1,192 5%
UnitedHealthcare $839 - $2,710 6%
Mvp $1,013 - $2,491 8%
Fidelis Care $1,073 8%
Humana $1,133 - $12,223 9%
Aetna $1,192 9%
Martins Point $1,192 9%
Veterans Choice $1,192 9%
Capital District Physicians' Health Plan $1,198 - $1,950 9%
Harvard Pilgrim $1,440 11%
Cigna $2,322 18%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 115 Porter Drive, Middlebury, VT 05753
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals