CMS Price Transparency Data

Total hip replacement

Facility: Physicians Regional Medical Center - Pine Ridge

Billing Code: 27130 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$15,042

about 1.1× the $13,117 Medicare rate · typically $9,194–$16,922

modeled estimate · not a bill or quote

What this hospital charges insurers

$13,488

Below the fair price — a good deal

about $1,554 under the fair price · 1.0× Medicare

Medicare pays $13,117 Fair price $15,042 This hospital $13,488 Cash price $36,453 Hospital's list price $173,584

How we calculate the fair BaseRate →

How this hospital compares to other FL hospitals

Highest price of the 9 FL hospitals we have prices for — worth calling around.

Cheapest $2,341 Priciest $13,488

Black dot = this hospital, among the 9 FL hospitals with a price for this procedure. Full list below.

A fair price for a Total hip replacement is about $15,042 (about 1.1× the $13,117 Medicare rate). Physicians Regional Medical Center - Pine Ridge charges insurers about $13,488, or about $36,453 in cash — below the fair price — a good deal. Located in Naples, FL.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$5,958 - $42,007	45%
Blue Cross Blue Shieldmajor	$13,174 - $29,041	100%
Aetnamajor	$13,174 - $115,259	100%
Cignamajor	$47,416	361%
Humanamajor	$6,137 - $13,174	47%
Ambetter (Centene)	$34,188	261%
Amerigroup	$6,494	50%
AvMed	$65,962	503%
HealthPartners	$69,047	526%
Simply Healthcare	$3,000 - $6,315	23%
WellCare	$6,256 - $13,809	48%
+ 9 smaller / regional plans	$5,958 - $33,518

Government programs also on file: Medicare, Medicaid, Military & VA.

Excludes 3 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 36,453), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 27130.

Insurance Before you use insurance

Call your insurance company to confirm Physicians Regional Medical Center - Pine Ridge is in-network.
Ask your insurer whether prior approval is required for CPT code 27130.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Physicians Regional Medical Center - Pine Ridge

Compare: Total hip replacement at other FL hospitals

Insurance negotiated median for the same procedure, sorted lowest first.