CMS Price Transparency Data

Total hip replacement

Facility: Saint Alphonsus Medical Center Ontario

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27130
  • Insurance Median: $499
  • Cash Discount Price: $1,016
  • vs. Medicare Baseline: 0.04x Medicare
The contracted insurance negotiated median rate for a Total hip replacement at Saint Alphonsus Medical Center Ontario is $499. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,016. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.04x the Medicare baseline. Located in 351 Sw 9Th Street, Ontario, OR.
Cash / Self-Pay
$1,016

Average discount available for prompt cash payment at this facility.

Insurance Median
$499

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: $1,016 (8%)
Insurance Median: $499 (4%)
Cash: $1,016 (8% of Medicare)
Ins. Median: $499 (4% 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

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Molina Marketplace $126 - $1,638 1%
Bcn Domestic $131 - $1,968 1%
Blue Benefit Administrators Of Massachusetts $131 - $1,968 1%
Blue Care Network $131 - $1,968 1%
Blue Cross Blue Shield $131 - $1,968 1%
Blue Distinction Transplant $131 - $1,968 1%
Blue Shield - Ca $131 - $1,968 1%
Blue Shield - Id (Regence) $131 - $2,053 1%
Blue Shield - Ny Highmark Northeastern $131 - $1,968 1%
Blue Shield - Ny Highmark Western $131 - $1,968 1%
Blue Shield - Pa (Highmark) $131 - $1,968 1%
Blue Shield - Wa (Regence) $131 - $1,968 1%
Health Choices $131 - $1,968 1%
Kaiser Domestic $131 - $1,968 1%
Pre-Employment $131 - $1,968 1%
Wc Domestic $131 - $1,968 1%
Aetna $132 - $2,496 1%
Align Senior Care $132 - $823 1%
Ally Align Care Adv $132 - $823 1%
American Health Plan $132 - $823 1%
Aurora Special Needs $132 - $823 1%
Blue Care Network Advantage $132 - $823 1%
Blue Shield - De (Highmark) Medciare Advantage $132 - $823 1%
Care Dimensions $132 - $823 1%
Care Improvement Plus $132 - $823 1%
Care Resources Pace $132 - $823 1%
Careplus Health Plans $132 - $823 1%
Cca - Zing Health $132 - $823 1%
Cca Senior Care Options $132 - $823 1%
Central Valley Medical Services Corp Pace $132 - $823 1%
Champion Health Plan Mcr Advantage $132 - $823 1%
Cigna $132 - $1,595 1%
Clear Spring Health $132 - $823 1%
Clover Health $132 - $823 1%
Commonwealth Care Alliance $132 - $823 1%
Community Pace At Home $132 - $823 1%
Eddy Senior Care-Pace $132 - $823 1%
Eddy Seniorcare Pace $132 - $823 1%
Elementcare $132 - $823 1%
Evercare $132 - $823 1%
Everence $132 - $823 1%
Gateway Health Plan $132 - $823 1%
Genesys Pace Of Genesee County $132 - $823 1%
Georgia Health Advantage $132 - $823 1%
Gold Advantage $132 - $823 1%
Gpa Croell Redi Mix $132 - $823 1%
Health America Advantra $132 - $823 1%
Highmark Health Options Dual Plan $132 - $823 1%
Hope Select Pace $132 - $823 1%
Horizon Nj Total Care $132 - $823 1%
Hudson Headwaters Pace $132 - $823 1%
Humana $132 - $4,440 1%
Huron Valley Pace $132 - $823 1%
Innovative Integrated Health Community Plans $132 - $823 1%
Iowa Health Advantage $132 - $823 1%
Johns Hopkins Advantage Md $132 - $823 1%
Lasso Healthcare Msa $132 - $823 1%
Life St Marys Pace $132 - $823 1%
Lifecircles Pace $132 - $823 1%
Longevity Health Plan $132 - $823 1%
Longevity Ipa Of Michigan Llc Health Plan Isnp $132 - $823 1%
Martins Point Generations Advantage $132 - $823 1%
Mass General Brigham Mcr Adv $132 - $823 1%
Medicare (plans) $132 - $924 1%
Medipak Advantage $132 - $823 1%
Mercy Life $132 - $823 1%
Mercyone Cedar Valley $132 - $823 1%
Meridian Complete $132 - $823 1%
Michigan Complete Health $132 - $823 1%
Nascentia Health Plus $132 - $823 1%
New Centry Health Careplus $132 - $823 1%
Osu Prime Care Advantage $132 - $823 1%
Pace Cny $132 - $823 1%
Pace Iowa Immanuel Pathways $132 - $823 1%
Pace Of Southwest Michigan $132 - $1,508 1%
Pace Southeast $132 - $823 1%
Pace-Trinity Health $132 - $823 1%
Peak Pace Solutions $132 - $823 1%
Perennial Advantage $132 - $823 1%
Preferred Care Partners $132 - $823 1%
Presbyterian Senior Plan $132 - $823 1%
Provider Partners Health Plan Of Illinois $132 - $823 1%
Provider Partners Health Plan Of Indiana $132 - $823 1%
Pruitthealth Premier $132 - $823 1%
Reliance Community Care Partners Care Resources Pace $132 - $823 1%
Rx Allwin $132 - $823 1%
Rx Grane Grnmedd $132 - $823 1%
Rx Retiree Rx Care $132 - $823 1%
Scan Health Plan Mcr Ipa Meritage Oon $132 - $823 1%
Secure Horizons Ma Pffs $132 - $823 1%
Serenity Pace $132 - $823 1%
Siouxland Pace $132 - $823 1%
Solis Health Plans $132 - $823 1%
Sunnyview-Pace Finance Dept $132 - $823 1%
Texan Plus $132 - $823 1%
The Health Plan $132 - $823 1%
Thome Pace $132 - $823 1%
Todays Options $132 - $823 1%
Tribute Health Plans $132 - $823 1%
Um Health Advantage $132 - $823 1%
Union Health Service $132 - $823 1%
UnitedHealthcare $132 - $2,176 1%
Welbe Health $132 - $823 1%
Wellmed $132 - $823 1%
Veterans Administration $134 - $840 1%
Asuris Northwest Health $137 - $2,053 1%
Healthcare Management Admin $137 - $2,053 1%
American Health Advantage Of Idaho $138 - $865 1%
Medicaid / KanCare $139 - $2,934 1%
Champva $145 - $905 1%
Tricare $145 - $905 1%
Triwest Health Alliance $145 - $905 1%
Us Family Health Plan $145 - $905 1%
Veterans Eval Services $145 - $905 1%
Moda Health $153 - $2,289 1%
Mountain Health Co-Op $153 - $2,289 1%
Selecthealth $153 - $2,308 1%
Meritain $154 - $1,443 1%
Albany County Correctional Facility $161 - $1,508 1%
Ambetter / Centene $161 - $1,508 1%
Amish Mennonite $161 - $1,508 1%
Ascension St. Vincent Public Safety Medical $161 - $1,508 1%
Bcccp-Michigan $161 - $1,508 1%
Bccp $161 - $1,508 1%
Bmc Healthnet $161 - $1,508 1%
Breast Grant-Connecticut $161 - $1,508 1%
Broward County Dept Of Health $161 - $1,508 1%
California Health And Wellness $161 - $1,508 1%
Can Community Health Inc $161 - $1,508 1%
Cardinal Innovations Lme $161 - $1,508 1%
Care Connections Of Northern Iowa $161 - $1,508 1%
Care Oregon Ohp $161 - $1,508 1%
Cencal Health Plan $161 - $1,508 1%
Cenpatico $161 - $1,508 1%
Chhuny $161 - $1,508 1%
Childrens Comm Health Plan $161 - $1,508 1%
Childrens Medical Services Title 19 $161 - $1,508 1%
City Of Philadelphia $161 - $1,508 1%
Cmh Allegan County $161 - $1,508 1%
Cmh Ausable Valley $161 - $1,508 1%
Cmh Barry County $161 - $1,508 1%
Cmh Bay-Arenac County $161 - $1,508 1%
Cmh Berrien County $161 - $1,508 1%
Cmh Cass County $161 - $1,508 1%
Cmh Central Mi County $161 - $1,508 1%
Cmh Clinton-Eaton-Ingham County $161 - $1,508 1%
Cmh Detroit Wayne Integrated Health Network $161 - $1,508 1%
Cmh Genesee County $161 - $1,508 1%
Cmh Ionia County $161 - $1,508 1%
Cmh Jackson County/Lifeways $161 - $1,508 1%
Cmh Kalamazoo $161 - $1,508 1%
Cmh Kent County $161 - $1,508 1%
Cmh Lenawee County $161 - $1,508 1%
Cmh Livingston County $161 - $1,508 1%
Cmh Macomb $161 - $1,508 1%
Cmh Misc $161 - $1,508 1%
Cmh Monroe County $161 - $1,508 1%
Cmh Montcalm County $161 - $1,508 1%
Cmh Muskegon County $161 - $1,508 1%
Cmh Newaygo County $161 - $1,508 1%
Cmh North Country $161 - $1,508 1%
Cmh Northern Lakes County $161 - $1,508 1%
Cmh Oakland County $161 - $1,508 1%
Cmh Ottawa County $161 - $1,508 1%
Cmh Van Buren County $161 - $1,508 1%
Cmh Washtenaw County $161 - $1,508 1%
Cmh Wayne County/Carelink $161 - $1,508 1%
Cmh Wayne Cty/Com Liv Svcs $161 - $1,508 1%
Cmh West Mi County $161 - $1,508 1%
Community Benefit Health $161 - $1,508 1%
Community Care Behavorial Health $161 - $1,508 1%
Community Care Partners $161 - $1,508 1%
Community Health Choice $161 - $1,508 1%
Connections Csp $161 - $1,508 1%
County Coroner $161 - $1,508 1%
County Funding Generic $161 - $1,508 1%
Covid19 Hrsa Uninsured Testing And Treatment Fund $161 - $1,508 1%
Dean Wi Badgercare $161 - $1,508 1%
Delaware County Department Of Health $161 - $1,508 1%
Delaware First Health $161 - $1,508 1%
Delta Dental Nj $161 - $1,508 1%
Dph Tb Program $161 - $1,508 1%
Dscc $161 - $1,508 1%
Eastpointe Lme $161 - $1,508 1%
Family Health Network $161 - $1,508 1%
Freedom First Healthcare $161 - $1,508 1%
Fresno County Ccs $161 - $1,508 1%
Ghc Scw Wi Badgercare $161 - $1,508 1%
Harbor Health $161 - $1,508 1%
Health Safety Net $161 - $1,508 1%
Healthy Blue Ne $161 - $1,508 1%
Hennepin Health $161 - $1,508 1%
Id County Ada $161 - $1,508 1%
Id County Canyon $161 - $1,508 1%
Id County Cat Fund $161 - $1,508 1%
Id County Other $161 - $1,508 1%
Id County Payette $161 - $1,508 1%
Idaho Dept Health And Wellfare $161 - $1,508 1%
Idaho Womens Health Check $161 - $1,508 1%
Indiana Breast Cervical Cancer $161 - $1,508 1%
Inland Empire Health Plan $161 - $1,508 1%
Intercommunity Health Ohp $161 - $1,508 1%
Iowa Total Care $161 - $1,508 1%
Jai Medical System $161 - $1,508 1%
Kern Family Health Plan $161 - $1,508 1%
Keystone First $161 - $1,508 1%
Keystone First Chip $161 - $1,508 1%
La Care Health Plan $161 - $1,508 1%
Lakeland Care Inc $161 - $1,508 1%
Managed Health Services - Indiana $161 - $1,508 1%
Maryland Breast & Cervical Program $161 - $1,508 1%
Maryland Healthy Smiles - Scion Dental $161 - $1,508 1%
Maryland Physicians Care $161 - $1,508 1%
Massachusetts Behavioral Health Partnership $161 - $1,508 1%
Mdwise $161 - $1,508 1%
Medi-Cal $161 - $1,508 1%
Medi-Cal Healthnet $161 - $1,508 1%
Medstar Dc Healthy Family $161 - $1,508 1%
Medstar Md Health Choice $161 - $1,508 1%
Mo Home State Health Plan $161 - $1,508 1%
Molina Centennial Care $161 - $1,508 1%
Nascentia Health Options $161 - $1,508 1%
Nebraska Total Care $161 - $1,508 1%
New York Cancer Services Program $161 - $1,508 1%
Nextlevel Health $161 - $1,508 1%
Paramount Advantage $161 - $1,508 1%
Parkland Community Health Plan $161 - $1,508 1%
Partners Behavioral Lme $161 - $1,508 1%
Peach State Healthplan $161 - $1,508 1%
Philadelphia County Funding $161 - $1,508 1%
Presbyterian Centennial Care $161 - $1,508 1%
Prestige Health Choice $161 - $1,508 1%
Priority Partners $161 - $1,508 1%
Robert F Sing Program $161 - $1,508 1%
Rx 340B Pass Along $161 - $1,508 1%
Rx Assistance/Rx Manufacturer Assistance 0 Copay $161 - $1,508 1%
Rx Medi-Cal $161 - $1,508 1%
Rx Meridian Rx $161 - $1,508 1%
Ryan White Florida Mssrp $161 - $1,508 1%
Sandhills Center Lme $161 - $1,508 1%
Screening For Life $161 - $1,508 1%
St Joseph County Hlth Dpt $161 - $1,508 1%
Stephenson Cty Health $161 - $1,508 1%
Sunshine State Health Plan $161 - $1,508 1%
Superior Health $161 - $1,508 1%
Tenncare $161 - $1,508 1%
Texas Children'S Health Plan $161 - $1,508 1%
Trillium Community Ohp $161 - $1,508 1%
Tufts Health Public Plans $161 - $1,508 1%
Vaya Health Lme $161 - $1,508 1%
Washtenaw Health Plan $161 - $1,508 1%
Webtpa $161 - $1,512 1%
Wellsense Health Plan $161 - $1,508 1%
Wi Womens Wellness $161 - $1,508 1%
First Choice Health $175 - $1,928 1%
Providence $175 - $1,928 1%
Pacificsource Health Plans $180 - $2,222 1%
Geha $197 - $2,176 2%
Andrie Inc $212 - $2,496 2%
East Greenbush Central School District $212 - $2,496 2%
Genex Wc $212 - $2,496 2%
Healthsmart Workers Comp $212 - $2,496 2%
Jag Source $212 - $2,496 2%
New York State Insurance Fund $212 - $2,496 2%
Njm Insurance Group $212 - $2,496 2%
Rx Heatlhcomp $212 - $2,496 2%
Rx Restat $212 - $2,496 2%
Rx Saif Opdp Wc $212 - $2,496 2%
Rx Worker'S Comp $212 - $2,496 2%
Wc Accident Fund $212 - $2,496 2%
Wc Ace $212 - $2,496 2%
Wc Acs Federal Employees $212 - $2,496 2%
Wc Acuity $212 - $2,496 2%
Wc Advantage $212 - $2,496 2%
Wc Aegis $212 - $2,496 2%
Wc Aig $212 - $2,496 2%
Wc Aims $212 - $2,496 2%
Wc Alaska National Ins $212 - $2,496 2%
Wc Align Network $212 - $2,496 2%
Wc Allied $212 - $2,496 2%
Wc Am Trust N America $212 - $2,496 2%
Wc American Claims Mgmt $212 - $2,496 2%
Wc Amerisure $212 - $2,496 2%
Wc Amtrust $212 - $2,496 2%
Wc Asu Risk Mgt $212 - $2,496 2%
Wc Benetech $212 - $2,496 2%
Wc Berkley Admin $212 - $2,496 2%
Wc Broadspire $212 - $2,496 2%
Wc Broward County $212 - $2,496 2%
Wc Bunch & Associates $212 - $2,496 2%
Wc California State Comp Ins $212 - $2,496 2%
Wc California State Ins Fund $212 - $2,496 2%
Wc Capitol Area Health Consortium $212 - $2,496 2%
Wc Ccmsi $212 - $2,496 2%
Wc Chartis $212 - $2,496 2%
Wc Chubb $212 - $2,496 2%
Wc Cirma $212 - $2,496 2%
Wc City Of Albany $212 - $2,496 2%
Wc City Of Sioux City $212 - $2,496 2%
Wc Claims Mgmt Inc $212 - $2,496 2%
Wc Cna $212 - $2,496 2%
Wc Comp One Admin C/O Manageability $212 - $2,496 2%
Wc Compone Admin $212 - $2,496 2%
Wc Corvel $212 - $2,496 2%
Wc Ct Healthcare Trust $212 - $2,496 2%
Wc Donegal Insurance Group $212 - $2,496 2%
Wc Emc Insurance Company $212 - $2,496 2%
Wc Employee Mutual $212 - $2,496 2%
Wc Enablecomp $212 - $2,496 2%
Wc Encore Health Network $212 - $2,496 2%
Wc Erie $212 - $2,496 2%
Wc Esis $212 - $2,496 2%
Wc Evolutions $212 - $2,496 2%
Wc Fcci $212 - $2,496 2%
Wc Fed Ex $212 - $2,496 2%
Wc Federal Black Lung $212 - $2,496 2%
Wc Federated $212 - $2,496 2%
Wc Finley Occupational Health $212 - $2,496 2%
Wc First Agency/Occunet $212 - $2,496 2%
Wc Ford Motor $212 - $2,496 2%
Wc Fresno Unified Emp $212 - $2,496 2%
Wc Gallagher Bassett $212 - $2,496 2%
Wc General Motors $212 - $2,496 2%
Wc Generic $212 - $2,496 2%
Wc Genex Care For Ohio $212 - $2,496 2%
Wc Great West Casualty $212 - $2,496 2%
Wc Guarantee Insurance $212 - $2,496 2%
Wc Guard Insurance Company $212 - $2,496 2%
Wc Hab $212 - $2,496 2%
Wc Hartford $212 - $2,496 2%
Wc Hastings $212 - $2,496 2%
Wc Health Management $212 - $2,496 2%
Wc Heritage Summit $212 - $2,496 2%
Wc Hireright $212 - $2,496 2%
Wc Horizon $212 - $2,496 2%
Wc Icw Group $212 - $2,496 2%
Wc Idaho State Ins Fund $212 - $2,496 2%
Wc Intercare Insurance $212 - $2,496 2%
Wc Intermountain $212 - $2,496 2%
Wc Johns Eastern $212 - $2,496 2%
Wc Kemberton $212 - $2,496 2%
Wc Key Ins & Benefit Solutions $212 - $2,496 2%
Wc Liberty Mutual $212 - $2,496 2%
Wc Mac Risk Management $212 - $2,496 2%
Wc Massachusetts $212 - $2,496 2%
Wc Mdia $212 - $2,496 2%
Wc Meadowbrook Claim $212 - $2,496 2%
Wc Medical Administrators $212 - $2,496 2%
Wc Meijers $212 - $2,496 2%
Wc Memic $212 - $2,496 2%
Wc Mercy Workcare $212 - $2,496 2%
Wc Michigan $212 - $2,496 2%
Wc Michigan Millers Mutual $212 - $2,496 2%
Wc Mitchell Frankenmuth $212 - $2,496 2%
Wc Mra $212 - $2,496 2%
Wc Nationwide $212 - $2,496 2%
Wc Nca Comp $212 - $2,496 2%
Wc New York $212 - $2,496 2%
Wc New York Special Funds $212 - $2,496 2%
Wc North American Rishces $212 - $2,496 2%
Wc Northeast Health $212 - $2,496 2%
Wc Notre Dame $212 - $2,496 2%
Wc Novanet $212 - $2,496 2%
Wc O'Hara Corp $212 - $2,496 2%
Wc Occ Health Allen $212 - $2,496 2%
Wc Ohio Bureau $212 - $2,496 2%
Wc One Call Medical $212 - $2,496 2%
Wc Paradigm $212 - $2,496 2%
Wc Peerless $212 - $2,496 2%
Wc Pma $212 - $2,496 2%
Wc Praxis Health Network $212 - $2,496 2%
Wc Price Chopper $212 - $2,496 2%
Wc Procura Management $212 - $2,496 2%
Wc Qualcare $212 - $2,496 2%
Wc Quiktrip $212 - $2,496 2%
Wc Reny Company $212 - $2,496 2%
Wc Rev Claims $212 - $2,496 2%
Wc Risico $212 - $2,496 2%
Wc Rural Mutual $212 - $2,496 2%
Wc Saif Oregon $212 - $2,496 2%
Wc Secura $212 - $2,496 2%
Wc Sedgwick $212 - $2,496 2%
Wc Sentry $212 - $2,496 2%
Wc Sheakley Unicomp $212 - $2,496 2%
Wc Smile Lodge $212 - $2,496 2%
Wc Society $212 - $2,496 2%
Wc Srs $212 - $2,496 2%
Wc Taconic (Mro) $212 - $2,496 2%
Wc Taconic Farms $212 - $2,496 2%
Wc Travelers $212 - $2,496 2%
Wc Triad Group $212 - $2,496 2%
Wc Tristar $212 - $2,496 2%
Wc Troy Ny $212 - $2,496 2%
Wc Tyson $212 - $2,496 2%
Wc Unified Health Services $212 - $2,496 2%
Wc United Heartland $212 - $2,496 2%
Wc Us Dept Of Labor $212 - $2,496 2%
Wc Velocity $212 - $2,496 2%
Wc Walmart $212 - $2,496 2%
Wc West Bend $212 - $2,496 2%
Wc West Bend Mutual/Argent $212 - $2,496 2%
Wc Winnebago Industries $212 - $2,496 2%
Wc Yankee Trails $212 - $2,496 2%
Wc York Risk $212 - $2,496 2%
Wc Zenith $212 - $2,496 2%
Wc Zurich $212 - $2,496 2%
Allied National Global Care $246 - $2,714 2%
Asrm - Reliance Standard Life Insurance $246 - $2,714 2%
Christian Care Ministry $246 - $2,714 2%
Dean Health $246 - $2,714 2%
Fallon Health $246 - $2,714 2%
Family Life Insurance Company $246 - $2,714 2%
Ghc Scw $246 - $2,714 2%
International Benefit Administrators $246 - $2,714 2%
Lifetime Benefit Solutions $246 - $2,714 2%
Manhattan Life $246 - $2,714 2%
Medi Share $246 - $2,714 2%
Multiplan $246 - $2,714 2%
Pai $246 - $2,714 2%
Pan-American Life $246 - $2,714 2%
Paramount Hmo $246 - $2,714 2%
Phcs $246 - $2,714 2%
Trinity Health Share $246 - $2,714 2%
Oregon Screenwise $503 4%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 351 Sw 9Th Street, Ontario, OR 97914
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals