CMS Price Transparency Data

Total hip replacement

Facility: Lower Keys Medical Center

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27130
  • Insurance Median: $14,107
  • Cash Discount Price: $39,047
  • vs. Medicare Baseline: 1.08x Medicare
The contracted insurance negotiated median rate for a Total hip replacement at Lower Keys Medical Center is $14,107. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $39,047. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 1.08x the Medicare baseline. Located in 5900 College Road, Key West, FL.
Cash / Self-Pay
$39,047

Average discount available for prompt cash payment at this facility.

Insurance Median
$14,107

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: $39,047 (298%)
Insurance Median: $14,107 (108%)
Cash: $39,047 (298% of Medicare)
Ins. Median: $14,107 (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 $1,290 10%
Simply Healthcare $3,000 - $9,997 23%
Florida Childrens Medical Services $9,088 69%
Medicaid / KanCare $9,088 - $9,997 69%
South Florida Community Care Network $9,088 69%
Humana $9,361 - $14,107 71%
Prime Health Work Comp Fl $9,560 73%
Fl Work Comp $9,855 75%
Heritage Summit Work Comp Fl $9,855 75%
Amerigroup $9,997 76%
Positive Healthcare $9,997 76%
Wellcare $9,997 76%
Wellcare Healthease $9,997 76%
Molina $10,270 78%
Prestige Health Choice $10,542 80%
Magellan $10,906 83%
Blue Cross Blue Shield $14,107 - $92,555 108%
Medicare (plans) $14,107 108%
Ultimate Health $14,107 108%
Node Non Par Hospice Agree $14,359 109%
Node United Behavioral Va Ccn $14,359 109%
Node Va $14,359 109%
UnitedHealthcare $14,359 - $111,211 109%
Correct Care Solutions $15,795 120%
Node Us Dept Of Labor $17,949 137%
State Auto Insurance Fl $28,718 219%
Self Pay $39,047 298%
Cigna $85,324 650%
Aetna $100,943 770%
Monroe County $108,463 827%
Evolutions Healthcare Systems $115,694 - $137,387 882%
Keys Energy $115,694 882%
Prime Health Ppo $115,694 882%
Avmed Health Plan $122,925 937%
Direct Healthcare $144,618 1103%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5900 College Road, Key West, FL 33040
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals