CMS Price Transparency Data

Total hip replacement

Facility: Thedacare Regional Medical Center - Appleton Inc

Billing Code: 27130 (CPT)

The BaseRate · fair price low confidence

A fair price for this

$8,838

about 0.7× the $13,117 Medicare rate · typically $1,952–$15,844

modeled estimate · not a bill or quote

What this hospital charges insurers

$5,297

Below the fair price — a good deal

about $3,541 under the fair price · 0.4× Medicare

Medicare pays $13,117 Fair price $8,838 This hospital $5,297 Cash price $4,165 Hospital's list price $7,437

How we calculate the fair BaseRate →

How this hospital compares to other WI hospitals

Highest price of the 9 WI hospitals we have prices for — worth calling around.

Cheapest $2,456 Priciest $5,297

Black dot = this hospital, among the 9 WI hospitals with a price for this procedure. Full list below.

A fair price for a Total hip replacement is about $8,838 (about 0.7× the $13,117 Medicare rate). Thedacare Regional Medical Center - Appleton Inc charges insurers about $5,297, or about $4,165 in cash — below the fair price — a good deal. Located in Appleton, WI.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

3 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Humana AetnaCignaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$4,034 - $11,820	31%
Blue Cross Blue Shieldmajor	$5,297 - $6,467	40%
Humanamajor	$6,364	49%
Quartz	$4,204	32%
+ 2 smaller / regional plans	$3,844 - $4,592

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 4,165), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 27130.

Insurance Before you use insurance

Call your insurance company to confirm Thedacare Regional Medical Center - Appleton Inc is in-network.
Ask your insurer whether prior approval is required for CPT code 27130.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Thedacare Regional Medical Center - Appleton Inc

Compare: Total hip replacement at other WI hospitals

Insurance negotiated median for the same procedure, sorted lowest first.