CMS Price Transparency Data

Total hip replacement

Facility: University of Iowa Health Care Medical Center Down

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27130
Insurance Median: $6,780
Cash Discount Price: $7,015
vs. Medicare Baseline: 0.52x Medicare

The contracted insurance negotiated median rate for a Total hip replacement at University of Iowa Health Care Medical Center Down is $6,780. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,015. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.52x the Medicare baseline. Located in 500 E Market Street, Iowa City, IA.

Cash / Self-Pay

$7,015

Average discount available for prompt cash payment at this facility.

Insurance Median

$6,780

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: $7,015 (53%)

Insurance Median: $6,780 (52%)

Cash: $7,015 (53% of Medicare)

Ins. Median: $6,780 (52% 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
Aetna	$1,146 - $12,107	9%
Iowa Total Care	$1,146 - $12,591	9%
Medical Associates	$1,146 - $6,545	9%
Molina Healthcare	$1,146	9%
UnitedHealthcare	$1,146 - $17,281	9%
Blue Cross Blue Shield	$1,157 - $12,228	9%
Healthpartners	$1,169 - $12,349	9%
Wellpoint (Amerigroup)	$1,203 - $12,713	9%
Immergrun	$2,506	19%
Aplos Health Plan	$2,924	22%
Quad City Community Healthcare	$3,886 - $7,516	30%
Midlands Choice	$4,027 - $4,737	31%
Oscar Health	$6,314	48%
Great River Health Systems	$7,015	53%
Sedgwick	$8,018	61%
Global Excel	$8,519	65%
Sanford Health Plan	$8,519	65%
Employee Benefit Systems	$8,819	67%
Sisco	$8,819	67%
Healthsmart	$9,020	69%
Hfn	$9,220	70%
Multiplan	$9,220	70%

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 $7,015.
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 University of Iowa Health Care Medical Center Down 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.