CMS Price Transparency Data

Total hip replacement

Facility: St Gabriels Hospital

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27130
Insurance Median: $2,047
Cash Discount Price: $2,083
vs. Medicare Baseline: 0.16x Medicare

The contracted insurance negotiated median rate for a Total hip replacement at St Gabriels Hospital is $2,047. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,083. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.16x the Medicare baseline. Located in 815 Southeast Second Street, Little Falls, MN.

Cash / Self-Pay

$2,083

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,047

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: $2,083 (16%)

Insurance Median: $2,047 (16%)

Cash: $2,083 (16% of Medicare)

Ins. Median: $2,047 (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
Blue Cross Blue Shield	$1,077 - $2,047	8%
Health Partners	$1,185 - $2,155	9%
Medica	$1,244 - $12,243	9%
Humana	$1,293	10%
Ucare	$1,357 - $3,160	10%
United	$2,621 - $2,873	20%
Multiplan	$3,411	26%
Sanford Health Plan	$3,411	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 $2,083.
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 Gabriels Hospital 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.