CMS Price Transparency Data

Total hip replacement

Facility: Clarinda Regional Health Center

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27130
  • Insurance Median: $2,906
  • Cash Discount Price: $3,305
  • vs. Medicare Baseline: 0.22x Medicare
The contracted insurance negotiated median rate for a Total hip replacement at Clarinda Regional Health Center is $2,906. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,305. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.22x the Medicare baseline. Located in 220 Essie Davison Drive, Clarinda, IA.
Cash / Self-Pay
$3,305

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,906

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: $3,305 (25%)
Insurance Median: $2,906 (22%)
Cash: $3,305 (25% of Medicare)
Ins. Median: $2,906 (22% 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
UnitedHealthcare $943 - $6,722 7%
Ambetter / Centene $1,047 - $7,469 8%
Coventry Health Mcr Adv $1,047 8%
Molina Mcr Adv-All Plans $1,047 8%
Blue Cross Blue Shield $1,068 8%
Midlands Choice-All Plans $2,450 19%
Amerigroup Ia Mcaid-All Plans $3,735 - $7,469 28%
Ia Total Care Mcaid-All Plans $3,735 - $7,469 28%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 220 Essie Davison Drive, Clarinda, IA 51632
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals