CMS Price Transparency Data

Total hip replacement

Facility: Gadsden Regional Medical Center

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27130
  • Insurance Median: $11,816
  • Cash Discount Price: $25,932
  • vs. Medicare Baseline: 0.90x Medicare
The contracted insurance negotiated median rate for a Total hip replacement at Gadsden Regional Medical Center is $11,816. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $25,932. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.90x the Medicare baseline. Located in 1007 Goodyear Avenue, Gadsden, AL.
Cash / Self-Pay
$25,932

Average discount available for prompt cash payment at this facility.

Insurance Median
$11,816

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: $25,932 (198%)
Insurance Median: $11,816 (90%)
Cash: $25,932 (198% of Medicare)
Ins. Median: $11,816 (90% 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.

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
Veterans Eval Services $1,139 9%
Medicaid / KanCare $2,376 18%
Viva Healthcare $3,900 30%
UnitedHealthcare $6,139 - $15,350 47%
Blue Cross Blue Shield $11,320 86%
Humana $11,320 86%
Medicare (plans) $11,320 86%
Node Viva Mcr Adv $11,320 86%
Node Select Health Mcr Adv $11,433 87%
Amedisys Hospice $11,515 88%
Gadsden Hospice $11,515 88%
Node Non Par Hospice Agree $11,515 88%
Node Va $11,515 88%
Southern Care Hospice $11,515 88%
Cigna $11,546 - $68,047 88%
Node Devoted Health Mcr Adv $11,546 88%
Node Clover Health Mcr Adv $11,630 89%
Aetna $11,658 - $111,938 89%
Node Wellcare Mcr Adv $11,746 90%
Node Eon Mcr Adv $11,886 91%
Prime Health $12,112 - $156,130 92%
Node Us Dept Of Labor $14,394 110%
Ambetter / Centene $17,273 132%
Self Pay $25,932 198%
American Employee Alliance $86,439 659%
Multiplan $123,175 - $136,141 939%
Magellan Behavioral $129,658 988%
First Health $151,268 - $174,499 1153%
Beech Street $157,751 1203%
Alamed Wc $162,073 1236%
Focus Health $165,314 1260%
Coventry Work Comp Al $168,988 1288%
Work Comp $183,683 1400%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1007 Goodyear Avenue, Gadsden, AL 35903
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals