CMS Price Transparency Data

Total hip replacement

Facility: The Orthopaedic Hospital of Lutheran Health Networ

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27130
  • Insurance Median: $1,929
  • Cash Discount Price: $963
  • vs. Medicare Baseline: 0.15x Medicare
The contracted insurance negotiated median rate for a Total hip replacement at The Orthopaedic Hospital of Lutheran Health Networ is $1,929. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $963. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.15x the Medicare baseline. Located in 7952 W Jefferson Blvd, Ft Wayne, IN.
Cash / Self-Pay
$963

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,929

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: $963 (7%)
Insurance Median: $1,929 (15%)
Cash: $963 (7% of Medicare)
Ins. Median: $1,929 (15% 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
Physicians Health Plan $324 - $63,818 2%
Amish Aid $366 - $13,408 3%
Self Pay $366 - $44,421 3%
Lutheran Preferred $395 - $98,713 3%
Php Freedom Network $424 - $51,561 3%
Cigna $475 - $164,521 4%
Aetna $528 - $79,793 4%
Three Rivers Preferred $542 - $74,035 4%
Sagamore $651 - $89,006 5%
Encore Ppo $677 - $82,261 5%
Multiplan $934 - $128,326 7%
Prime Health Services $1,016 - $123,391 8%
First Health $1,043 - $126,681 8%
Encore $1,083 - $131,617 8%
One Call Work Comp $1,192 9%
UnitedHealthcare $12,012 - $26,103 92%
Blue Cross Blue Shield $13,346 - $55,822 102%
Humana $13,346 - $26,103 102%
Iu Health Plan $13,346 102%
Medicare (plans) $13,346 102%
Node Mhs Mcr Adv $13,346 102%
Small Business Aid $13,346 - $13,347 102%
Node Hospice Non Par Agree $13,583 104%
Node Va $13,583 104%
Node Devoted Health Mcr Adv $13,613 104%
Police And Sheriff $13,844 106%
In Dept Of Correction $14,127 108%
Node Pphp Mcr Adv $14,263 109%
Node Us Dept Of Labor $16,979 129%
Medicaid / KanCare $20,080 - $26,103 153%
Lutheran Advanced Network $20,375 155%
Node Lutheran Three Rivers Preferred Plus 150 $20,375 155%
Occunet In Work Comp $20,375 155%
Align Network $21,734 166%
Node Lutheran Three Rivers Preferred Plus 175 $23,771 181%
Encore Wc $24,450 186%
Medrisk In Work Comp $24,450 186%
Three Rivers Preferred In Work Comp $24,450 186%
Caresource $26,103 199%
Managed Health Services $26,103 - $27,167 199%
Mhs $26,103 199%
Objective Surgical $26,488 202%
In Work Comp $27,167 207%
Lutheran Network $27,167 207%
Encore Kba Epo $32,600 249%
Encore Kba Ppo $40,750 311%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7952 W Jefferson Blvd, Ft Wayne, IN 46804
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals