CMS Price Transparency Data

Total hip replacement

Facility: Mat-Su Regional Medical Center

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27130
Insurance Median: $90,362
Cash Discount Price: $43,374
vs. Medicare Baseline: 6.89x Medicare

The contracted insurance negotiated median rate for a Total hip replacement at Mat-Su Regional Medical Center is $90,362. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $43,374. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 6.89x the Medicare baseline. Located in 2500 South Woodworth Loop, Palmer, AK.

Cash / Self-Pay

$43,374

Average discount available for prompt cash payment at this facility.

Insurance Median

$90,362

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: $43,374 (331%)

Insurance Median: $90,362 (689%)

Cash: $43,374 (331% of Medicare)

Ins. Median: $90,362 (689% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 689% of the Medicare baseline (a markup of 589%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Veterans Eval Services	$1,564	12%
Medicare (plans)	$14,990	114%
Node Non Par Hospice Agree	$15,260	116%
Node Triwest	$15,260	116%
Node Va	$15,260	116%
Medicaid / KanCare	$15,499	118%
Node Us Dept Of Labor	$19,075	145%
Self Pay	$43,374	331%
Ak Dept Of Corrections	$79,519	606%
Blue Cross Blue Shield	$81,109 - $88,194	618%
Hccmca	$86,748	661%
Aetna	$92,531	705%
Multiplan Phcs	$109,881	838%
Moda Assurance	$114,218	871%
Cigna	$114,507	873%
Carlie Trans Grp	$122,893	937%
UnitedHealthcare	$122,893	937%
First Choice Health	$130,122	992%
Multiplan Mpi	$131,568	1003%
Plan Vista Solutions	$134,459	1025%
Multiplan Wc	$137,351	1047%
One Health	$137,351	1047%
First Health Group	$138,797	1058%
Medical Control Network Solutions	$138,797	1058%

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 $43,374.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 27130.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Mat-Su Regional Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 27130.
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.