CMS Price Transparency Data

Total knee replacement

Facility: Richland Hospital

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $1,337
Cash Discount Price: $7,017
vs. Medicare Baseline: 0.10x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at Richland Hospital is $1,337. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,017. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.10x the Medicare baseline. Located in 333 E Second St, Richland Center, WI.

Cash / Self-Pay

$7,017

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,337

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: $7,017 (53%)

Insurance Median: $1,337 (10%)

Cash: $7,017 (53% of Medicare)

Ins. Median: $1,337 (10% 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
Blue Cross Blue Shield	$1,050 - $7,455	8%
Security Health	$1,050	8%
Group Health Coop Of Eau Claire	$1,087 - $1,208	8%
Care Wisconsin	$1,208 - $1,337	9%
Dean Health Plan	$1,208 - $5,442	9%
Health Tradition	$1,208 - $8,332	9%
Humana	$1,208	9%
Quartz	$1,208 - $12,455	9%
UnitedHealthcare	$1,208 - $7,017	9%
Aetna	$7,455	57%
Cigna	$7,455	57%
Employer Health Care Alliance	$7,455	57%

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 $7,017.
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 Richland 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.