CMS Price Transparency Data

Total hip replacement

Facility: Essentia Health Virginia

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27130
  • Insurance Median: $12,628
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.96x Medicare
The contracted insurance negotiated median rate for a Total hip replacement at Essentia Health Virginia is $12,628. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.96x the Medicare baseline. Located in 901 9Th Street North, Virginia, MN.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$12,628

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%)
Insurance Median: $12,628 (96%)
Ins. Median: $12,628 (96% 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
Advocare/Security Health $12,628 96%
Blue Cross Blue Shield $12,628 - $46,772 96%
Freedom Blue Ppo $12,628 96%
Healthpartners Care Msho / Mcr Adv $12,628 96%
Imcare Msho Pcc Prime $12,628 96%
Imcare Msho Ref Req $12,628 96%
Medica Advantage Solutions $12,628 96%
Medica Msho/Dual Solutions $12,628 96%
Medica Prime Solution Group $12,628 96%
Medicare (plans) $12,628 96%
Nd Va Administration $12,628 96%
Platinum Blue/Vantage Blue $12,628 96%
Primewest Msho $12,628 96%
Secure Blue Msho $12,628 96%
Ubh Cost Plan $12,628 96%
Ubh Msho $12,628 96%
Ucare Msho $12,628 96%
UnitedHealthcare $12,628 96%
Primewest $12,689 97%
Itasca Med Care $12,867 98%
Sanford Healthplan $22,784 174%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 901 9Th Street North, Virginia, MN 55792
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals