CMS Price Transparency Data

Total hip replacement

Facility: Baldwin Health

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27130
  • Insurance Median: $14,112
  • Cash Discount Price: $24,799
  • vs. Medicare Baseline: 1.08x Medicare
The contracted insurance negotiated median rate for a Total hip replacement at Baldwin Health is $14,112. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $24,799. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 1.08x the Medicare baseline. Located in 1613 North McKenzie Street, Foley, AL.
Cash / Self-Pay
$24,799

Average discount available for prompt cash payment at this facility.

Insurance Median
$14,112

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: $24,799 (189%)
Insurance Median: $14,112 (108%)
Cash: $24,799 (189% of Medicare)
Ins. Median: $14,112 (108% 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%
UnitedHealthcare $6,283 - $30,476 48%
Triwest $11,936 91%
Blue Cross Blue Shield $11,971 - $13,000 91%
Humana $11,971 91%
Medicare (plans) $11,971 91%
Windsor Health Plan $11,971 91%
Community Hospice $12,179 93%
Hospice $12,179 93%
Mercy Medical Hospice $12,179 93%
Node Va $12,179 93%
Cigna $12,210 - $45,489 93%
Node Devoted Health Mcr Adv $12,210 93%
Node Clover Health Mcr Adv $12,301 94%
Select Health $12,301 94%
Aetna $12,330 - $123,995 94%
Node Wellcare Mcr Adv $12,423 95%
Us Dol $15,224 116%
Ambetter / Centene $18,269 139%
First Choice $19,731 150%
Self Pay $24,799 189%
American Employee Alliance $55,109 420%
Multiplan $78,530 - $112,974 599%
First Health $103,330 - $111,251 788%
Alamed $105,396 804%
Multiplan Inc $105,396 804%
Coventry Work Comp Al $107,738 821%
Pro America $110,218 840%
Novanet $111,251 848%
Alabama Wc $117,107 893%
Gulf Health $117,107 893%
Principal Ppo $117,107 893%
Viva Health $117,107 893%
National Health $123,995 945%
Galaxy $125,373 956%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1613 North McKenzie Street, Foley, AL 36535
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals