CMS Price Transparency Data

Total hip replacement

Facility: North Alabama Medical Center

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27130
Insurance Median: $11,977
Cash Discount Price: $4,587
vs. Medicare Baseline: 0.91x Medicare

The contracted insurance negotiated median rate for a Total hip replacement at North Alabama Medical Center is $11,977. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,587. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.91x the Medicare baseline. Located in 1701 Veterans Drive, Florence, AL.

Cash / Self-Pay

$4,587

Average discount available for prompt cash payment at this facility.

Insurance Median

$11,977

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: $4,587 (35%)

Insurance Median: $11,977 (91%)

Cash: $4,587 (35% of Medicare)

Ins. Median: $11,977 (91% 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
Blue Cross Blue Shield	$1,181 - $11,477	9%
Cigna	$7,439	57%
UnitedHealthcare	$11,020 - $17,027	84%
Viva Health, Inc	$11,381	87%
Aetna	$11,977	91%
Humana	$12,329	94%
Ambetter / Centene	$14,326	109%

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 $4,587.
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 North Alabama 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.