CMS Price Transparency Data

Total hip replacement

Facility: Deaconess Illinois Crossroads

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27130
Insurance Median: $3,636
Cash Discount Price: $2,155
vs. Medicare Baseline: 0.28x Medicare

The contracted insurance negotiated median rate for a Total hip replacement at Deaconess Illinois Crossroads is $3,636. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,155. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.28x the Medicare baseline. Located in 8 Doctors Park Rd, Mount Vernon, IL.

Cash / Self-Pay

$2,155

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,636

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: $2,155 (16%)

Insurance Median: $3,636 (28%)

Cash: $2,155 (16% of Medicare)

Ins. Median: $3,636 (28% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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	$1,247 - $13,681	10%
Blue Cross Blue Shield	$1,247 - $13,413	10%
Humana	$1,247 - $13,413	10%
Meridian Health Plan	$1,247 - $13,413	10%
Molina Healthcare Of Illinois	$1,247 - $13,547	10%
Mytru Advantage	$1,247 - $13,413	10%
Umwa	$1,247 - $13,413	10%
UnitedHealthcare	$1,247 - $13,413	10%
Wellcare	$1,247 - $13,413	10%
Alliance Coal	$1,721 - $22,131	13%
Alter-Net Medical Services, Inc.	$1,995 - $38,226	15%
Noncontracted	$1,995 - $21,460	15%
Self-Pay	$2,155	16%
Cigna	$2,395	18%
Deaconess Onecare	$2,556	19%
Prime Health Services	$4,618	35%
Guardian Resources, Inc.	$5,172	39%
Healthcare'S Finest Network (Hfn)	$5,233	40%
Medicalcontrol Network Solutions	$5,233	40%
National Provider Network	$5,233	40%
Three Rivers Provider Network	$5,357	41%
Beech Street	$5,418	41%
Care Improvement Plus	$13,681	104%
Hope Trust	$38,226	291%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $2,155.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 27130.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Deaconess Illinois Crossroads is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 27130.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.