CMS Price Transparency Data

Total hip replacement

Facility: Astera Health

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27130
Insurance Median: $2,110
Cash Discount Price: $2,759
vs. Medicare Baseline: 0.16x Medicare

The contracted insurance negotiated median rate for a Total hip replacement at Astera Health is $2,110. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,759. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.16x the Medicare baseline. Located in 421 11Th Street Nw, Wadena, MN.

Cash / Self-Pay

$2,759

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,110

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: $2,759 (21%)

Insurance Median: $2,110 (16%)

Cash: $2,759 (21% of Medicare)

Ins. Median: $2,110 (16% 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
Sanford Health Plan [10120]	$232 - $1,181	2%
Blue Plus Pmap [40002]	$744 - $1,181	6%
Ucare Pmap [30006]	$884 - $20,035	7%
Health Partners Pmap [10046]	$912 - $27,686	7%
Medica Pmap [10057]	$912 - $20,531	7%
Primewest Pmap [30003]	$912 - $20,531	7%
Blue Cross Blue Shield	$1,181 - $41,860	9%
Health Partners [10045]	$1,181 - $39,355	9%
Medica Nonpmap [10056]	$1,181 - $297,700	9%
Primewest Non Pmap [30004]	$1,181	9%
Ucare Non Pmap [30007]	$1,181 - $23,118	9%
UnitedHealthcare	$1,712 - $42,548	13%
Ucare Commercial [10705]	$2,841 - $40,918	22%
Multiplan	$3,057 - $44,034	23%
Aetna	$3,439 - $49,538	26%

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 $2,759.
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 Astera 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.