Total knee replacement
Facility: Regional Medical Center
Billing Code: 27447 (CPT)
- CPT Billing Code: 27447
- Insurance Median: $870
- Cash Discount Price: $12,796
- vs. Medicare Baseline: 0.07x 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 |
|---|---|---|
| Medical Associates Health Plan - Tri | $870 | 7% |
Consumer Guidance & Cost Commentary
For a total knee replacement at Regional Medical Center in Manchester, IA, the facility's cash price of $12,796 is notably lower than the gross charge of $15,996, offering a significant potential savings for patients who pay upfront. While the Medicare benchmark amount of $13,116.76 serves as a baseline for fair cost, the cash rate is approximately 96% of the Medicare amount, making it an attractive option if you have a high-deductible plan where the insurance negotiated rate might exceed this cash price. It is important to note that the facility's ownership is Government - Local, and while the facility holds a high rating of 4, the specific cash price remains the most direct comparison for self-pay patients.
Patients should be aware that insurance plans, such as Medical Associates Health Plan - Tri, have a negotiated rate of $870, which is substantially lower than the cash price; however, this rate may not apply if you do not have this specific plan or if you have not met your deductible. To ensure you receive the best possible price, you should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling your visit, as these can reduce the final bill further. Additionally, if you receive a summary bill, do not accept it as the final invoice; instead, request a full itemized CPT-coded statement to verify that no services were unbundled or double-charged, as over 80% of hospital bills contain errors that can be corrected through a formal written audit dispute.