CMS Price Transparency Data

Total hip replacement

Facility: Halifax Health Medical Center

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27130
  • Insurance Median: $12,915
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a Total hip replacement at Halifax Health Medical Center is $12,915. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.98x the Medicare baseline. Located in 303 N Clyde Morris Blvd, Daytona Beach, FL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$12,915

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%)
Insurance Median: $12,915 (98%)
Ins. Median: $12,915 (98% 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
Embs $10,978 84%
Tricare $12,115 92%
Humana $12,528 - $25,702 96%
Aetna $12,915 - $27,260 98%
Americas Choice Provider Network $12,915 98%
Blue Cross Blue Shield $12,915 98%
Cigna $12,915 98%
Coventry $12,915 98%
Division Of The Blind $12,915 98%
Freedom Health $12,915 98%
Medicare (plans) $12,915 98%
Optimum Healthcare $12,915 98%
Sunshine State Health Plan $12,915 - $25,831 98%
UnitedHealthcare $12,915 98%
Wellcare $12,915 98%
Molina $13,174 100%
Devoted Health $13,432 102%
Independent Living Systems $13,561 103%
Longevity $13,561 103%
Prime Health Services $13,561 103%
Clear Spring Health Of Fl $14,078 107%
Evolutions $19,373 148%
Employers Health Network $25,831 197%
Fhcp $26,089 199%
Centivo $27,768 212%
Florida Healthcare $28,027 214%
Claimdoc $29,060 222%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 303 N Clyde Morris Blvd, Daytona Beach, FL 32114
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals