CMS Price Transparency Data

Total hip replacement

Facility: Memorial Hospital Pembroke

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27130
Insurance Median: $14,882
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.13x Medicare

The contracted insurance negotiated median rate for a Total hip replacement at Memorial Hospital Pembroke is $14,882. 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 1.13x the Medicare baseline. Located in 7800 Sheridan St, Pembroke Pines, FL.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$14,882

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: $14,882 (113%)

Ins. Median: $14,882 (113% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Broward County	$718	5%
Corvel	$10,938	83%
Employers Choice Network	$10,938	83%
First Health	$10,938	83%
Gallagher Bassett	$10,938	83%
Prime Health Services	$10,938	83%
Wellcare	$14,212 - $14,614	108%
Florida Community Care	$14,346	109%
Humana	$14,480	110%
Aetna	$14,882	113%
Doctors Healthcare Plans	$15,150	116%
Solis Health Plan	$15,150	116%
Health Sun	$15,284	117%
Florida Pace Centers	$15,418	118%
Longevity	$15,418	118%
UnitedHealthcare	$16,089	123%
Align Senior Care	$16,357	125%
Gold Kidney	$16,357	125%
Sunshine	$18,100 - $25,474	138%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $X.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 27130.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Memorial Hospital Pembroke is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 27130.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.