CMS Price Transparency Data

Total knee replacement

Facility: Margaretville Memorial Hospital

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27447
  • Insurance Median: $22,000
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.68x Medicare
The contracted insurance negotiated median rate for a Total knee replacement at Margaretville Memorial Hospital is $22,000. 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 1.68x the Medicare baseline. Located in 42084 State Highway 28, Margaretville, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$22,000

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: $22,000 (168%)
Ins. Median: $22,000 (168% 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.

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
Mvp Exchange $3,616 28%
Mvp Hmo/Ppo $4,254 32%
Aetna $5,730 - $22,000 44%
UnitedHealthcare $6,769 - $22,000 52%
Oxford Exchange $7,167 55%
Blue Cross Blue Shield $7,674 - $22,000 59%
Emblem Ghi/Hip Ppo/Cbp $8,786 67%
Self-Pay $9,976 76%
Magnacare Preferred $10,333 79%
Hamaspik (McR) $22,000 168%
Medicare (plans) $22,000 - $23,540 168%
Mvp Gold (McR) $22,000 168%
Affinity By Molina McR $23,100 176%
Cdphp $24,200 184%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 42084 State Highway 28, Margaretville, NY 12455
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals