Total knee replacement
Facility: Oakleaf Surgical Hospital
Billing Code: 27447 (CPT)
- CPT Billing Code: 27447
- Insurance Median: $12,717
- Cash Discount Price: $7,641
- vs. Medicare Baseline: 0.97x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Blue Cross Blue Shield | $12,717 - $22,837 | 97% |
| Dean Health Plan | $12,717 | 97% |
| Group Health Cooperative Of Eau Claire | $12,717 | 97% |
| Healthpartners | $12,717 | 97% |
| Humana | $12,717 | 97% |
| Medica | $12,717 | 97% |
| Quartz Health Solutions | $12,717 | 97% |
| Security Health Plan Of Wi | $12,717 - $26,175 | 97% |
| Ucare Wi | $12,717 | 97% |
| UnitedHealthcare | $12,717 | 97% |
| Alliance | $19,075 | 145% |
Consumer Guidance & Cost Commentary
For a self-pay patient, the most important fact to know immediately is that the cash price for a Total knee replacement at Oakleaf Surgical Hospital is $7,641. This amount is significantly lower than the facility's gross chargemaster rate of $8,490 and represents a substantial discount compared to the negotiated rates commercial insurers typically pay. Because insurance contracts often include administrative overheads and multi-layered billing structures, the cash price can be the most cost-effective option for patients with high-deductible plans or those who have already met their out-of-pocket maximum, avoiding the higher negotiated rates that insurance carriers are contractually required to pay.
From a broader pricing perspective, the facility's cash rate of $7,641 is notably lower than the median negotiated rate of $12,717 paid by insurance payers, as well as the median paid rate of $7,509. While the cash price is lower than the negotiated rates, it is slightly higher than the median paid rate, which reflects the actual amounts insurers have historically paid for this procedure. The facility is located in Altoona, Wisconsin, and operates as an Acute Care Hospital owned by physicians. Patients are encouraged to verify if the hospital offers specific "self-pay" or "prompt-pay" discounts that could further reduce the final bill, and to always request an itemized billing audit before agreeing to pay any amount to ensure there are no errors or unbundled charges.