CMS Price Transparency Data

Total hip replacement

Facility: Decatur County Hospital

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27130
  • Insurance Median: $2,666
  • Cash Discount Price: $2,922
  • vs. Medicare Baseline: 0.20x Medicare
The contracted insurance negotiated median rate for a Total hip replacement at Decatur County Hospital is $2,666. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,922. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.20x the Medicare baseline. Located in 1405 Nw Church Street, Leon, IA.
Cash / Self-Pay
$2,922

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,666

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: $2,922 (22%)
Insurance Median: $2,666 (20%)
Cash: $2,922 (22% of Medicare)
Ins. Median: $2,666 (20% 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
Aetna $1,047 8%
Tricare $1,047 8%
UnitedHealthcare $1,047 - $3,104 8%
Amerigroup Mcaid-All Plans $1,100 8%
Everystep Hospice-All Plans $1,899 14%
Wellmark Hmo $2,377 18%
Wellmark Ppo - All Other Plans $2,377 18%
Misc Commercial-All Plans $2,666 20%
Rural Carrier Benefit Plan-All Plans $2,812 21%
Midlands Choice-All Plans $2,830 22%
Christian Healthcare -All Plans $2,922 22%
Ntca The Rural Broadband-All Plans $3,104 24%
Farm Bureau Financial-All Other Plans $3,287 25%
Farm Bureau Property And Ca $3,287 25%
Priority Health-All Plans $3,652 28%
Iowa Total Care Mcaid-All Plans $3,725 28%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1405 Nw Church Street, Leon, IA 50144
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals