CMS Price Transparency Data
Total hip replacement
Facility: Stoughton Hospital
Billing Code: 27130 (CPT)
The BaseRate · fair price low confidence
A fair price for this
$4,384
about 0.3× the $13,117 Medicare rate · typically $1,354–$16,035
modeled estimate · not a bill or quote
Medicare pays $13,117 Fair price $4,384 Cash price $12,201 Hospital's list price $22,183
What each insurance company pays
Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.
5 of 6 major insurers have a published price at this hospital
✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser 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 | $1,052 - $17,746 | 8% |
| Blue Cross Blue Shieldmajor | $2,583 | 20% |
| Aetnamajor | $1,052 - $17,303 | 8% |
| Cignamajor | $17,746 | 135% |
| Humanamajor | $1,481 - $19,965 | 11% |
| Dean Health Plan | $1,052 - $3,088 | 8% |
| GEHA | $16,637 | 127% |
| Health Net | $894 | 7% |
| Quartz | $1,052 - $2,745 | 8% |
| + 2 smaller / regional plans | $3,398 - $3,893 |
Government programs also on file: Medicaid, Military & VA.
Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.
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Other Procedures at Stoughton Hospital
Compare: Total hip replacement at other WI hospitals
- Thedacare Medical Center - New London · New London $2,456
- Thedacare Medical Center - Berlin Inc · Berlin $3,271
- Upland Hills Health · Dodgeville $3,326
- Thedacare Medical Center - Shawano · Shawano $3,427
- Unitypoint Health - Meriter · Madison $3,835
- Ascension Ne Wisconsin - St Elizabeth Campus · Appleton $4,830
- Ascension Columbia St Marys Hospital Milwaukee · Milwaukee $5,281
- Ascension Sacred Heart Rehabilitation Hospital · Mequon $5,281
Insurance negotiated median for the same procedure, sorted lowest first.