CMS Price Transparency Data

Total knee replacement

Facility: Forks Community Hospital

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $9,298
Cash Discount Price: $15,406
vs. Medicare Baseline: 0.71x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at Forks Community Hospital is $9,298. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $15,406. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.71x the Medicare baseline. Located in 530 Bogachiel Way, Forks, WA.

Cash / Self-Pay

$15,406

Average discount available for prompt cash payment at this facility.

Insurance Median

$9,298

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: $15,406 (117%)

Insurance Median: $9,298 (71%)

Cash: $15,406 (117% of Medicare)

Ins. Median: $9,298 (71% 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
Medicare (plans)	$318	2%
Medicaid / KanCare	$6,173 - $7,573	47%
Coordinated Care (Mco) Mcd-All Plans	$6,668 - $7,718	51%
UnitedHealthcare	$7,945 - $17,564	61%
Community Health Network Mcr-All Other Plans	$8,033 - $9,298	61%
Humana	$8,033 - $9,298	61%
Tricare	$8,033 - $9,298	61%
Triwest-All Plans	$8,033 - $9,298	61%
Ambetter / Centene	$9,319 - $10,786	71%
Wellcare Med Adv - All Plans	$9,319 - $10,786	71%
Regence-All Other Plans	$10,279 - $11,898	78%
Community Health Exchange	$11,604 - $13,431	88%
Molina Commercial-All Other Plans	$16,424 - $19,010	125%
Blue Cross Blue Shield	$16,959 - $19,630	129%
Aetna	$17,852 - $20,663	136%
Cigna	$17,852 - $20,663	136%
First Choice-All Plans	$17,852 - $20,663	136%

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 $15,406.
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 Forks Community 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.