CMS Price Transparency Data

Total hip replacement

Facility: Memorial Hospital and Health Care Center

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27130
Insurance Median: $2,968
Cash Discount Price: $2,155
vs. Medicare Baseline: 0.23x Medicare

The contracted insurance negotiated median rate for a Total hip replacement at Memorial Hospital and Health Care Center is $2,968. 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 0.23x the Medicare baseline. Located in 800 W 9Th St, Jasper, IN.

Cash / Self-Pay

$2,155

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,968

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: $2,968 (23%)

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

Ins. Median: $2,968 (23% 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
Blue Cross Blue Shield	$976 - $13,479	7%
Aetna	$1,154 - $13,479	9%
Caresource In Marketplace	$1,154 - $16,849	9%
Humana	$1,154 - $13,479	9%
Tricare	$1,154 - $11,457	9%
Mdwise	$1,159	9%
Mhs Hoosier Care Connect	$1,159	9%
Immergrun	$1,385 - $16,175	11%
Ambetter / Centene	$1,500 - $17,523	11%
Noncontracted	$1,847 - $21,566	14%
Onecare	$1,904	15%
Siho	$1,904	15%
Chamber Care	$1,943	15%
UnitedHealthcare	$2,373 - $40,437	18%
Encore	$3,662	28%
Encore Elite +	$3,662 - $32,350	28%
Patoka Valley	$3,912	30%
Cigna	$4,055	31%
Sagamore	$4,055	31%

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 Memorial Hospital and Health Care 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.