CMS Price Transparency Data

Total hip replacement

Facility: Aurora St Lukes Medical Center

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27130
Insurance Median: $21,931
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.67x Medicare

The contracted insurance negotiated median rate for a Total hip replacement at Aurora St Lukes Medical Center is $21,931. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 1.67x the Medicare baseline. Located in 2900 W Oklahoma Ave, Milwaukee, WI.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$21,931

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%)

Insurance Median: $21,931 (167%)

Ins. Median: $21,931 (167% 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	$10,471	80%
Blue Cross Blue Shield	$18,105 - $23,358	138%
Common Ground	$19,078	145%
Everpointe Elite	$19,372	148%
Molina Exchange	$20,231	154%
UnitedHealthcare	$20,679 - $22,691	158%
Quartz One	$21,170	161%
Health Payment Systems	$23,200	177%
Centivo	$24,314	185%
Aurora Caregiver	$24,750	189%
Hs Technology	$24,761	189%
Quartz Group	$24,770	189%
Wisconsin Physician Service	$26,005 - $27,374	198%
Trilogy	$29,247	223%

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 $X.
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 Aurora St Lukes Medical Center 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.