CMS Price Transparency Data

Total hip replacement

Facility: Schneck Medical Center

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27130
Insurance Median: $32,508
Cash Discount Price: $12,019
vs. Medicare Baseline: 2.48x Medicare

The contracted insurance negotiated median rate for a Total hip replacement at Schneck Medical Center is $32,508. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $12,019. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 2.48x the Medicare baseline. Located in 411 W Tipton St, Seymour, IN.

Cash / Self-Pay

$12,019

Average discount available for prompt cash payment at this facility.

Insurance Median

$32,508

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: $12,019 (92%)

Insurance Median: $32,508 (248%)

Cash: $12,019 (92% of Medicare)

Ins. Median: $32,508 (248% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 248% of the Medicare baseline (a markup of 148%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Blue Cross Blue Shield	$32,508	248%

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 $12,019.
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 Schneck Medical Center 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.