CMS Price Transparency Data

Total hip replacement

Facility: HCA Florida Raulerson Hospital

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27130
  • Insurance Median: $22,438
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.71x Medicare
The contracted insurance negotiated median rate for a Total hip replacement at HCA Florida Raulerson Hospital is $22,438. 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 1.71x the Medicare baseline. Located in 1796 Hwy 441 North, Okeechobee, FL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$22,438

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: $22,438 (171%)
Ins. Median: $22,438 (171% 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
Corvel Corporation $995 - $9,363 8%
Careworks (Rockport) $1,016 - $9,560 8%
Prime Health $1,016 - $9,560 8%
Freedom Health $1,495 - $2,350 11%
Molina $1,950 - $2,702 15%
Health Sun Health Plan $2,050 16%
Simply Healthcare Plans $2,160 16%
Optimum $2,350 18%
Prominence Healthfirst $11,000 84%
Cigna $11,166 - $16,759 85%
Florida Complete Care $15,300 117%
Devoted Health $16,759 128%
American Health Plan $17,429 133%
Blue Cross Blue Shield $21,742 - $24,677 166%
Avmed $23,133 - $39,037 176%
Aetna $24,476 - $29,886 187%
Humana $34,002 259%
United $43,000 328%
Oscar $44,616 340%
Simply Healthcare $52,111 397%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1796 Hwy 441 North, Okeechobee, FL 34972
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals