Total hip replacement
Facility: Oakleaf Surgical Hospital
Billing Code: 27130 (CPT)
- CPT Billing Code: 27130
- Insurance Median: $12,717
- Cash Discount Price: $7,383
- vs. Medicare Baseline: 0.97x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Blue Cross Blue Shield | $12,717 - $24,978 | 97% |
| Dean Health Plan | $12,717 | 97% |
| Group Health Cooperative Of Eau Claire | $12,717 | 97% |
| Healthpartners | $12,717 | 97% |
| Humana | $12,717 | 97% |
| Medica | $12,717 | 97% |
| Quartz Health Solutions | $12,717 | 97% |
| Security Health Plan Of Wi | $12,717 - $26,175 | 97% |
| Ucare Wi | $12,717 | 97% |
| UnitedHealthcare | $12,717 | 97% |
| Alliance | $19,075 | 145% |
Consumer Guidance & Cost Commentary
Oakleaf Surgical Hospital, located at 1000 Oakleaf Way in Altoona, Wisconsin, provides the following pricing information for a Total hip replacement (CPT 27130) as of the 2026-06 vintage. The facility's cash median rate is $7,383, while the median negotiated rate across 11 payers is $12,717, and the median paid amount is $7,491. For reference, the Medicare amount for this procedure is $13,116.76. The cash rate of $7,383 is lower than the cash median of $7,383, which aligns with the facility's specific pricing structure for this service.
Patients should note that while the cash rate of $7,383 appears competitive, the median negotiated rate of $12,717 represents the amount commercial insurers typically pay. Because the negotiated rate exceeds the cash price, patients with high-deductible plans or those paying out-of-pocket might find the cash rate more advantageous, provided they qualify for prompt-pay discounts. It is essential to confirm with the hospital regarding "self-pay" or "prompt-pay" discounts before scheduling, as these can further reduce the final cost. Additionally, under the No Surprises Act, patients are protected from balance billing for out-of-network services at in-network facilities, and they should always request a full itemized, CPT-coded bill to verify all charges rather than accepting summary invoices.