CMS Price Transparency Data

Total hip replacement

Facility: McKenzie County Healthcare Systems Inc

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27130
Insurance Median: $46,215
Cash Discount Price: $32,830
vs. Medicare Baseline: 3.52x Medicare

The contracted insurance negotiated median rate for a Total hip replacement at McKenzie County Healthcare Systems Inc is $46,215. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $32,830. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 3.52x the Medicare baseline. Located in 709 4Th Ave Ne, Watford City, ND.

Cash / Self-Pay

$32,830

Average discount available for prompt cash payment at this facility.

Insurance Median

$46,215

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: $32,830 (250%)

Insurance Median: $46,215 (352%)

Cash: $32,830 (250% of Medicare)

Ins. Median: $46,215 (352% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 352% of the Medicare baseline (a markup of 252%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Humana	$24,244	185%
Sanford Health Plan	$24,244 - $48,993	185%
Blue Cross Blue Shield	$24,729 - $33,941	189%
Medica	$30,810 - $49,498	235%
First Choice Plus	$44,447	339%
UnitedHealthcare	$47,983 - $49,498	366%

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 $32,830.
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 McKenzie County Healthcare Systems Inc 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.