CMS Price Transparency Data

Total hip replacement

Facility: Jefferson County Health Center

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27130
  • Insurance Median: $818
  • Cash Discount Price: $1,069
  • vs. Medicare Baseline: 0.06x Medicare
The contracted insurance negotiated median rate for a Total hip replacement at Jefferson County Health Center is $818. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,069. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.06x the Medicare baseline. Located in 2000 S Main, Fairfield, IA.
Cash / Self-Pay
$1,069

Average discount available for prompt cash payment at this facility.

Insurance Median
$818

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: $1,069 (8%)
Insurance Median: $818 (6%)
Cash: $1,069 (8% of Medicare)
Ins. Median: $818 (6% 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 $606 - $1,604 5%
Tricare $691 5%
Amerigroup Mcr Adv $713 5%
Humana $713 5%
Iowa Total Care Comm - All Other Plans $713 5%
Iowa Total Care Mcr $713 5%
Molina Mcr Adv $713 5%
Iowa Total Care Mcaid $748 6%
Molina Mcaid/Chip $748 6%
Medicaid / KanCare $763 6%
Aetna $873 - $1,604 7%
Medicare (plans) $873 7%
Midlands New Product $1,461 11%
Coventry Commercial Hmo $1,515 12%
Coventry Commercial Ppo - All Other Plans $1,604 12%
Midlands Choice-All Other Plans $1,604 12%
Molina Marketplace - All Other Plans $1,782 14%
Wellmark Hmo $19,447 148%
Wellmark Indemnity/Ppo - All Other Plans $21,397 163%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2000 S Main, Fairfield, IA 52556
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals