CMS Price Transparency Data

Total hip replacement

Facility: Mercyone Des Moines Medical Center

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27130
  • Insurance Median: $13,117
  • Cash Discount Price: $47,350
  • vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a Total hip replacement at Mercyone Des Moines Medical Center is $13,117. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $47,350. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 1.00x the Medicare baseline. Located in 1111 6Th Ave, Des Moines, IA.
Cash / Self-Pay
$47,350

Average discount available for prompt cash payment at this facility.

Insurance Median
$13,117

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: $47,350 (361%)
Insurance Median: $13,117 (100%)
Cash: $47,350 (361% of Medicare)
Ins. Median: $13,117 (100% 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
Iowa Total Care $12,118 92%
Aetna $12,153 93%
Medicare (plans) $12,153 - $12,649 93%
Medicaid / KanCare $12,237 - $12,285 93%
Blue Cross Blue Shield $12,274 - $13,117 94%
UnitedHealthcare $12,396 95%
Blue Benefit Administrators Of Massachusetts $13,117 100%
Blue Care Network $13,117 100%
Blue Distinction Transplant $13,117 100%
Blue Shield - Ca $13,117 100%
Blue Shield - Id (Regence) $13,117 100%
Blue Shield - Ny Highmark Northeastern $13,117 100%
Blue Shield - Ny Highmark Western $13,117 100%
Blue Shield - Pa (Highmark) $13,117 100%
Blue Shield - Wa (Regence) $13,117 100%
Amish Hospital Aid $16,493 126%
Oscar $17,621 134%
Centivo $17,894 136%
Ambetter / Centene $20,833 159%
Claimdoc $24,925 190%
Nova $24,925 190%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1111 6Th Ave, Des Moines, IA 50314
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals