CMS Price Transparency Data

Total knee replacement

Facility: Bellin Health Oconto Hospital

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $31,464
Cash Discount Price: $27,300
vs. Medicare Baseline: 2.40x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at Bellin Health Oconto Hospital is $31,464. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $27,300. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 2.40x the Medicare baseline. Located in 820 Arbutus Ave, Oconto, WI.

Cash / Self-Pay

$27,300

Average discount available for prompt cash payment at this facility.

Insurance Median

$31,464

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: $27,300 (208%)

Insurance Median: $31,464 (240%)

Cash: $27,300 (208% of Medicare)

Ins. Median: $31,464 (240% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 240% of the Medicare baseline (a markup of 140%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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	$14,280 - $32,424	109%
Community Care	$14,280	109%
Humana	$14,280	109%
My Choice	$14,280	109%
Network Health	$14,280 - $35,700	109%
UnitedHealthcare	$17,220 - $29,358	131%
Aetna	$21,000	160%
Cigna	$29,694 - $30,198	226%
Common Ground	$30,568 - $31,429	233%
Chorus Community Health Plan	$31,500	240%
Aspirus Arise	$32,878	251%
Healthsmart	$33,600	256%
Ihs(Claimsbridge)	$33,600	256%
Medical College Of Wi	$33,600	256%
Hps/Paymedix	$34,440 - $37,380	263%
Wps Insurance	$35,267	269%
Allied National	$35,700	272%
First Health	$35,700	272%
Galaxy Health	$35,700	272%
Three Rivers Provider Network	$37,800	288%
Trilogy	$37,800	288%

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 $27,300.
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 Bellin Health Oconto 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.