CMS Price Transparency Data

Total knee replacement

Facility: Charleston Area Medical Center

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $1,494
Cash Discount Price: $3,718
vs. Medicare Baseline: 0.11x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at Charleston Area Medical Center is $1,494. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,718. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.11x the Medicare baseline. Located in 501 Morris Street, Charleston, WV.

Cash / Self-Pay

$3,718

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,494

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: $3,718 (28%)

Insurance Median: $1,494 (11%)

Cash: $3,718 (28% of Medicare)

Ins. Median: $1,494 (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
Aetna	$981 - $1,350	7%
The Health Plan Of West Virginia Inc.	$981 - $1,867	7%
Unicare Health Plan Of West Virginia Inc.	$981	7%
Triwest Va	$1,132	9%
Blue Cross Blue Shield	$1,167 - $2,038	9%
Choicecare Network	$1,167 - $1,494	9%
Optimum Choice Inc.	$1,167	9%
UnitedHealthcare	$1,167 - $1,202	9%
West Virginia Senior Advantage Inc.	$1,225	9%
City Of Charleston	$1,517	12%
Naphcare	$1,599	12%
Integrated Medical Solutions	$1,692	13%
Caresource	$1,750	13%
Tricare	$2,231	17%
Three Rivers Providers Network	$3,606	27%
Healthsmart	$3,644	28%
Multiplan	$3,644	28%
Cigna	$3,681	28%

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 $3,718.
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 Charleston Area Medical Center 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.