CMS Price Transparency Data

Total hip replacement

Facility: Montrose Regional Health

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27130
Insurance Median: $3,591
Cash Discount Price: $3,058
vs. Medicare Baseline: 0.27x Medicare

The contracted insurance negotiated median rate for a Total hip replacement at Montrose Regional Health is $3,591. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,058. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.27x the Medicare baseline. Located in 800 S 3Rd St, Montrose, CO.

Cash / Self-Pay

$3,058

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,591

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: $3,058 (23%)

Insurance Median: $3,591 (27%)

Cash: $3,058 (23% of Medicare)

Ins. Median: $3,591 (27% 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
Blue Cross Blue Shield	$1,165 - $7,300	9%
Humana	$1,165 - $6,601	9%
Medicare (plans)	$1,165	9%
United Rocky Mountain Chp-All Other Plans	$1,922	15%
UnitedHealthcare	$1,929	15%
United Rocky Mountain Private Plan	$1,945	15%
United Rocky Mountain Self Insured	$1,945	15%
Three Rivers-All Plans	$3,161 - $6,989	24%
Western Healthcare Alliance-All Plans	$3,161 - $6,989	24%
Cigna	$3,336 - $7,378	25%
Multiplan-All Plans	$3,336 - $7,378	25%
Uchpa - All Plans	$3,336 - $7,378	25%
United Rocky Mountain Mcaid	$3,512 - $7,766	27%
Sloans Lake Managed Care-All Plans	$4,071	31%

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 $3,058.
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 Montrose Regional Health 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.