CMS Price Transparency Data

Total hip replacement

Facility: North Okaloosa Medical Center

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27130
  • Insurance Median: $13,174
  • Cash Discount Price: $37,445
  • vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a Total hip replacement at North Okaloosa Medical Center is $13,174. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $37,445. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 1.00x the Medicare baseline. Located in 151 Redstone Ave Se, Crestview, FL.
Cash / Self-Pay
$37,445

Average discount available for prompt cash payment at this facility.

Insurance Median
$13,174

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: $37,445 (285%)
Insurance Median: $13,174 (100%)
Cash: $37,445 (285% of Medicare)
Ins. Median: $13,174 (100% 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 $1,290 10%
Amerigroup $5,958 45%
Medicaid / KanCare $5,958 45%
UnitedHealthcare $5,958 - $41,189 45%
Simply Healthcare $6,077 - $13,832 46%
Humana $6,137 - $13,832 47%
Integral Health $6,256 48%
Wellcare $6,256 - $13,569 48%
Magellan Health $6,405 49%
Prestige Health $6,911 53%
Evolutions $10,058 - $183,064 77%
Usa Managed Care Work Comp Fl $10,058 77%
Prime Health Work Comp Fl $10,269 78%
Amcomp Workers Comp $10,587 81%
Blue Cross Blue Shield $10,964 - $15,402 84%
Aetna $11,340 - $156,020 86%
Cigna $13,174 - $162,261 100%
Medicare (plans) $13,174 100%
Node Non Par Hospice Agree $13,407 102%
Node Va $13,407 102%
Florida Department Of Corrections $14,491 110%
Node Us Dept Of Labor $16,759 128%
State Auto Insurance Fl $26,814 204%
Occunet $33,518 256%
Self Pay $37,445 285%
Oscar $38,857 296%
Corizon Health Inc $70,313 536%
Phcs $187,224 1427%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 151 Redstone Ave Se, Crestview, FL 32539
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals