CMS Price Transparency Data

Total knee replacement

Facility: Prosser Memorial Hospital

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $1,445
Cash Discount Price: $2,537
vs. Medicare Baseline: 0.11x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at Prosser Memorial Hospital is $1,445. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,537. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.11x the Medicare baseline. Located in 723 Memorial Street, Prosser, WA.

Cash / Self-Pay

$2,537

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,445

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: $2,537 (19%)

Insurance Median: $1,445 (11%)

Cash: $2,537 (19% of Medicare)

Ins. Median: $1,445 (11% 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
Community Health Plan Of Washington	$730 - $1,445	6%
Coordinated Care	$730	6%
Kaiser Permanente	$730 - $3,211	6%
UnitedHealthcare	$730 - $1,445	6%
Molina	$766 - $1,445	6%
Amerigroup	$774	6%
Health Alliance Northwest	$1,445	11%
Humana	$1,445	11%
Wellcare	$1,445	11%
Cigna	$1,616	12%
Aetna	$1,624 - $1,705	12%
Premera	$1,720	13%
Asuris	$1,956	15%
Health Management Adminstrators	$1,956	15%
Regence	$1,956	15%
Ambetter / Centene	$2,601	20%
Multiplan	$3,921	30%

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 $2,537.
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 Prosser Memorial 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.