CMS Price Transparency Data

Total knee replacement

Facility: Southern Hills Hospital and Medical Center

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $10,550
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.80x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at Southern Hills Hospital and Medical Center is $10,550. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.80x the Medicare baseline. Located in 9300 West Sunset Rd, Las Vegas, NV.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$10,550

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%)

Insurance Median: $10,550 (80%)

Ins. Median: $10,550 (80% 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
Community Care Health	$1,294	10%
Sierra Hpn	$1,294	10%
Molina Healthcare	$1,294 - $1,346	10%
Caresource	$1,346	10%
Ambetter / Centene	$2,626	20%
Select Health	$3,894 - $14,000	30%
Aetna	$3,996 - $4,396	30%
Cigna	$6,461	49%
United	$8,928 - $27,118	68%
Legacy Provider Network	$9,446	72%
Corvel	$9,971	76%
Health Services Coalition	$10,196 - $10,604	78%
Olympus Medsave USA	$10,496	80%
Humana	$14,000	107%
Sierra	$16,379 - $19,125	125%
Hometown Health Providers	$17,722 - $21,916	135%
Blue Cross Blue Shield	$18,516 - $24,082	141%

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 $X.
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 Southern Hills Hospital and 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.