CMS Price Transparency Data

Total hip replacement

Facility: Merit Health Wesley

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27130
  • Insurance Median: $11,433
  • Cash Discount Price: $21,039
  • vs. Medicare Baseline: 0.87x Medicare
The contracted insurance negotiated median rate for a Total hip replacement at Merit Health Wesley is $11,433. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $21,039. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.87x the Medicare baseline. Located in 5001 W Hardy St, Hattiesburg, MS.
Cash / Self-Pay
$21,039

Average discount available for prompt cash payment at this facility.

Insurance Median
$11,433

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: $21,039 (160%)
Insurance Median: $11,433 (87%)
Cash: $21,039 (160% of Medicare)
Ins. Median: $11,433 (87% 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
Veterans Eval Services $1,156 9%
Aetna $1,200 - $11,545 9%
Medicaid / KanCare $2,376 - $15,278 18%
UnitedHealthcare $4,131 - $11,402 31%
Ms Dept Of Rehabilitation Services $8,796 67%
Cigna $9,504 72%
Magnolia $9,805 - $11,209 75%
Magnolia Mcd Ms Chip $9,805 75%
Caresource Truecare $10,001 76%
Molina Chip $10,589 81%
First Choice $11,209 - $80,147 85%
Humana $11,209 85%
Medicare (plans) $11,209 85%
Node Vantage Mcr Adv $11,209 85%
Node Hospice Non Par Agree $11,402 87%
Node Va $11,402 87%
Molina $11,433 87%
Node Devoted Health Mcr Adv $11,433 87%
Node First Choice American Health Mcr Adv $11,433 87%
Node First Choice Wellcare Mcr Adv $11,630 89%
Node Healthy Mississippi Mcr Adv $12,542 96%
Node Us Dept Of Labor $14,252 109%
Blue Cross Blue Shield $17,827 136%
Advanced Health Systems $17,990 137%
Molina Exchange $19,108 146%
First Choice Molina $19,383 148%
Magnolia Exchange $19,953 152%
Chs Group Health Plan $20,037 153%
Self Pay $21,039 160%
Ms Work Comp $22,103 169%
First Choice Lgp $24,856 189%
Vantage Health $25,654 196%
Trimed Billing Solutions $30,055 229%
Benefit Management Services $65,119 496%
Coventry First Health $75,138 573%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5001 W Hardy St, Hattiesburg, MS 39402
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals