CMS Price Transparency Data

Total hip replacement

Facility: The East Alabama Healthcare Authority

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27130
Insurance Median: $11,661
Cash Discount Price: $13,009
vs. Medicare Baseline: 0.89x Medicare

The contracted insurance negotiated median rate for a Total hip replacement at The East Alabama Healthcare Authority is $11,661. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $13,009. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.89x the Medicare baseline. Located in 2000 Pepperell Parkway, Opelika, AL.

Cash / Self-Pay

$13,009

Average discount available for prompt cash payment at this facility.

Insurance Median

$11,661

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: $13,009 (99%)

Insurance Median: $11,661 (89%)

Cash: $13,009 (99% of Medicare)

Ins. Median: $11,661 (89% 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	$182 - $24,371	1%
Blue Cross Blue Shield	$182 - $14,336	1%
Cigna	$182 - $22,943	1%
Humana	$182 - $23,331	1%
Simpra	$182 - $11,661	1%
Viva	$182 - $28,974	1%
Novanet	$3,548	27%
Beechstreet	$11,049 - $20,104	84%
Alabama Crime Victims	$11,826	90%
Mcm Maxcare	$18,922	144%
Mega Life	$18,922	144%
UnitedHealthcare	$18,922	144%
Coventry First Health	$20,104	153%
Geha	$20,104	153%
Multiplan	$20,104	153%
Workers Comp	$20,104	153%
Trpn	$21,287	162%

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 $13,009.
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 The East Alabama Healthcare Authority 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.