CMS Price Transparency Data

Total hip replacement

Facility: Perham Health

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27130
Insurance Median: $1,705
Cash Discount Price: $3,078
vs. Medicare Baseline: 0.13x Medicare

The contracted insurance negotiated median rate for a Total hip replacement at Perham Health is $1,705. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,078. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.13x the Medicare baseline. Located in 1000 Coney Street West, Perham, MN.

Cash / Self-Pay

$3,078

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,705

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: $3,078 (23%)

Insurance Median: $1,705 (13%)

Cash: $3,078 (23% of Medicare)

Ins. Median: $1,705 (13% 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	$1,314 - $3,204	10%
Health Partners Mcr Adv	$1,610	12%
Humana	$1,610	12%
Medica Mcr Adv	$1,610	12%
Medicare (plans)	$1,610 - $1,894	12%
Ucare Mn Senior Health Options	$1,610	12%
UnitedHealthcare	$1,657 - $3,693	13%
Ucare Mn Special Needs Basic Care Dual	$1,690	13%
Ucare Mn Medical Assistance	$1,705	13%
Ucare Mn Minnesota Care	$1,705	13%
Ucare Mn Senior Care Plus	$1,705	13%
Ucare Mn Special Needs Basic Care	$1,705	13%
Medicaid / KanCare	$1,707	13%
Medica Mcaid Mn Care	$1,733	13%
Medica Mn (Msho)	$1,951	15%
Health Partners Minnesota Care	$2,368	18%
Ucare Individual And Family Plan-All Other Plans	$2,368	18%
Medica Commercial-All Other Plans	$3,466	26%
Preferred One (Pchp, Pic, Pas)-All Other Plans	$3,551	27%
Health Partners-All Plans	$3,883	30%
Preferred One (Ppo)	$4,025	31%
Sanford Health Plan-All Plans	$4,025	31%

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 $3,078.
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 Perham 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.