CMS Price Transparency Data

Total hip replacement

Facility: Santa Rosa Medical Center

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27130
  • Insurance Median: $13,407
  • Cash Discount Price: $20,872
  • vs. Medicare Baseline: 1.02x Medicare
The contracted insurance negotiated median rate for a Total hip replacement at Santa Rosa Medical Center is $13,407. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $20,872. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 1.02x the Medicare baseline. Located in 6002 Berryhill Rd, Milton, FL.
Cash / Self-Pay
$20,872

Average discount available for prompt cash payment at this facility.

Insurance Median
$13,407

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: $20,872 (159%)
Insurance Median: $13,407 (102%)
Cash: $20,872 (159% of Medicare)
Ins. Median: $13,407 (102% 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%
Medicaid / KanCare $5,958 - $6,911 45%
Humana $6,137 - $13,174 47%
Wellcare $6,256 48%
Molina $6,733 51%
Fl Community Care $6,852 52%
Prime Health Work Comp Fl $9,765 74%
Florida Workers Compensation $10,067 77%
Aetna $13,174 - $78,063 100%
Blue Cross Blue Shield $13,174 - $26,302 100%
Cigna $13,174 - $31,448 100%
Medicare (plans) $13,174 100%
UnitedHealthcare $13,174 - $26,995 100%
Node Va $13,407 102%
Node Wellcare Mcr Adv $13,832 105%
Geo Group $16,759 128%
Node Us Dept Of Labor $16,759 128%
Florida State Auto Insurance $26,814 204%
Self Pay $32,004 244%
Ambetter / Centene $32,043 244%
Oscar $40,411 308%
Hospice Of Nw Fl $69,575 530%
Prime Health Services $111,320 849%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6002 Berryhill Rd, Milton, FL 32570
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals