CMS Price Transparency Data

Total hip replacement

Facility: Adventist Health Tillamook

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27130
Insurance Median: $1,821
Cash Discount Price: $2,172
vs. Medicare Baseline: 0.14x Medicare

The contracted insurance negotiated median rate for a Total hip replacement at Adventist Health Tillamook is $1,821. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,172. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.14x the Medicare baseline. Located in 1000 Third Street, Tillamook, OR.

Cash / Self-Pay

$2,172

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,821

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: $2,172 (17%)

Insurance Median: $1,821 (14%)

Cash: $2,172 (17% of Medicare)

Ins. Median: $1,821 (14% 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
Aetna	$1,120 - $2,334	9%
Moda Health Plan - All Plans	$1,143	9%
Sterling Life - All Plans	$1,165	9%
Medicare (plans)	$1,176	9%
Devoted Health	$1,210	9%
Blue Cross Blue Shield	$1,288 - $5,383	10%
Hvhs Mcare - All Plans	$1,356	10%
Lifewise - All Plans	$1,676 - $5,581	13%
Ah Employee Health Plan - All Plans	$1,747 - $5,816	13%
First Choice Health- All Plans	$1,747 - $5,816	13%
Health Net - All Plans	$1,747 - $5,816	13%
Providence Preferred - All Plans	$1,821 - $6,064	14%
Workers Comp	$1,858 - $6,188	14%
UnitedHealthcare	$2,374	18%
Pacificsource - All Plans	$2,714	21%
Ods Health Plan - All Other Plans	$2,941	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 $2,172.
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 Adventist Health Tillamook 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.