CMS Price Transparency Data

Total hip replacement

Facility: Saint Agnes Medical Center

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27130
  • Insurance Median: $16,363
  • Cash Discount Price: $50,386
  • vs. Medicare Baseline: 1.25x Medicare
The contracted insurance negotiated median rate for a Total hip replacement at Saint Agnes Medical Center is $16,363. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $50,386. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 1.25x the Medicare baseline. Located in 1303 E Herndon Ave, Fresno, CA.
Cash / Self-Pay
$50,386

Average discount available for prompt cash payment at this facility.

Insurance Median
$16,363

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: $50,386 (384%)
Insurance Median: $16,363 (125%)
Cash: $50,386 (384% of Medicare)
Ins. Median: $16,363 (125% 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
Medi-Cal Healthnet $181 1%
Blue Benefit Administrators Of Massachusetts $5,754 44%
Blue Care Network $5,754 44%
Blue Cross Blue Shield $5,754 - $34,240 44%
Blue Distinction Transplant $5,754 44%
Blue Shield - Ca $5,754 44%
Blue Shield - Id (Regence) $5,754 44%
Blue Shield - Ny Highmark Northeastern $5,754 44%
Blue Shield - Ny Highmark Western $5,754 44%
Blue Shield - Pa (Highmark) $5,754 44%
Blue Shield - Wa (Regence) $5,754 44%
Aetna $16,182 123%
Humana $16,182 - $17,008 123%
UnitedHealthcare $16,363 - $17,082 125%
Medicare (plans) $16,857 - $17,008 129%
Welbe Health $16,992 130%
Geha $17,082 130%
Align Senior Care $18,990 145%
Kaiser Permanente $28,897 220%
Advantek Central Usd $34,240 261%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1303 E Herndon Ave, Fresno, CA 93720
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals