CMS Price Transparency Data

Total knee replacement

Facility: Cody Regional Health

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $8,933
Cash Discount Price: $8,436
vs. Medicare Baseline: 0.68x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at Cody Regional Health is $8,933. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8,436. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.68x the Medicare baseline. Located in 707 Sheridan Avenue, Cody, WY.

Cash / Self-Pay

$8,436

Average discount available for prompt cash payment at this facility.

Insurance Median

$8,933

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: $8,436 (64%)

Insurance Median: $8,933 (68%)

Cash: $8,436 (64% of Medicare)

Ins. Median: $8,933 (68% 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
Mountain Health - All Plans	$1,124	9%
Tricare	$1,124	9%
Medica Comm - All Other Plans	$1,229	9%
Pacific Source - All Plans	$2,232	17%
Blue Cross Blue Shield	$6,368 - $9,429	49%
Christian Hlthcare - All Plans	$7,940	61%
Cigna	$8,932	68%
First Choice Health - All Plans	$8,932	68%
Humana	$8,932	68%
Interwest Health Ppo - All Plans	$9,131	70%
First Health Ntwrk-All Plans	$9,230	70%
Three Rivers - All Plans	$9,429	72%
UnitedHealthcare	$9,429	72%

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 $8,436.
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 Cody Regional Health 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.