CMS Price Transparency Data

Total hip replacement

Facility: St Luke's Nampa Medical Center

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27130
Insurance Median: $13,506
Cash Discount Price: $15,889
vs. Medicare Baseline: 1.03x Medicare

The contracted insurance negotiated median rate for a Total hip replacement at St Luke's Nampa Medical Center is $13,506. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $15,889. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 1.03x the Medicare baseline. Located in 9850 West St Lukes Drive, Nampa, ID.

Cash / Self-Pay

$15,889

Average discount available for prompt cash payment at this facility.

Insurance Median

$13,506

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: $15,889 (121%)

Insurance Median: $13,506 (103%)

Cash: $15,889 (121% of Medicare)

Ins. Median: $13,506 (103% 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	$10,328 - $27,116	79%
Commercial [1028]	$10,328 - $27,116	79%
Mountain Health Co-Op [1067]	$10,328 - $19,214	79%
Pacificsource [1020]	$10,328 - $19,214	79%
Select Health [1063]	$10,328 - $19,214	79%
Slplan Tap Mc St Lukes Health Plan [1641000001]	$10,328 - $19,214	79%
St Lukes Health Plan [1046]	$10,328 - $19,214	79%
Aetna	$12,711 - $14,300	97%
Cigna	$12,711	97%
Providence [1022]	$12,711	97%
Webtpa [1071]	$12,711 - $13,506	97%
Geha [1065]	$13,029	99%
United Medical Resources [1051]	$13,029	99%
UnitedHealthcare	$13,029 - $13,621	99%
First Health [1064]	$13,108 - $13,506	100%
Moda [1055]	$13,982	107%
Regence [1005]	$25,760 - $27,116	196%
Blue Shield Alt [100401]	$27,116	207%
Regence Out Of State [1004]	$27,116	207%

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 $15,889.
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 St Luke's Nampa 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.