CMS Price Transparency Data

Total hip replacement

Facility: Samaritan North Lincoln Hospital

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27130
Insurance Median: $2,106
Cash Discount Price: $4,220
vs. Medicare Baseline: 0.16x Medicare

The contracted insurance negotiated median rate for a Total hip replacement at Samaritan North Lincoln Hospital is $2,106. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,220. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.16x the Medicare baseline. Located in 3043 Ne 28Th Street, Lincoln City, OR.

Cash / Self-Pay

$4,220

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,106

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: $4,220 (32%)

Insurance Median: $2,106 (16%)

Cash: $4,220 (32% of Medicare)

Ins. Median: $2,106 (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
Pacificsource	$1,085 - $2,808	8%
Samaritan	$1,206 - $2,969	9%
Cigna	$1,208 - $2,417	9%
Devoted Health	$1,231 - $1,387	9%
Healthnet	$1,231 - $2,870	9%
Humana	$1,231 - $1,448	9%
Ihn	$1,354 - $1,381	10%
Regence	$1,386 - $4,029	11%
Moda	$1,517 - $4,220	12%
Providence	$1,617 - $4,220	12%
Aetna	$2,105 - $2,807	16%
First Choice	$2,898	22%

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 $4,220.
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 Samaritan North Lincoln 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.