CMS Price Transparency Data

Total hip replacement

Facility: Merit Health River Oaks

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27130
  • Insurance Median: $17,820
  • Cash Discount Price: $40,613
  • vs. Medicare Baseline: 1.36x Medicare
The contracted insurance negotiated median rate for a Total hip replacement at Merit Health River Oaks is $17,820. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $40,613. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 1.36x the Medicare baseline. Located in 1030 River Oaks Drive, Flowood, MS.
Cash / Self-Pay
$40,613

Average discount available for prompt cash payment at this facility.

Insurance Median
$17,820

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: $40,613 (310%)
Insurance Median: $17,820 (136%)
Cash: $40,613 (310% of Medicare)
Ins. Median: $17,820 (136% 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%
Ms Dept Of Rehabilitation Services $7,381 56%
Medicaid / KanCare $9,805 - $34,408 75%
UnitedHealthcare $9,805 - $60,243 75%
Magnolia Mcd Chip $9,903 75%
Caresource Truecare $10,001 76%
Molina Chip $10,589 81%
Humana $11,394 87%
Medicare (plans) $11,394 87%
Node First Choice Shared Health Of Ms Mcr Adv $11,394 87%
Node Vantage Health Mcr Adv $11,394 87%
Node Hospice Non Par Agree $11,592 88%
Node Va $11,592 88%
Molina $11,622 89%
Node Devoted Health Mcr Adv $11,622 89%
Node First Choice American Health Mcr Adv $11,622 89%
Aetna $11,736 - $157,939 89%
Node First Choice Wellcare Mcr Adv $11,823 90%
Node Healthy Mississippi Mcr Adv $12,751 97%
Node Us Dept Of Labor $14,489 110%
First Choice Preferred $17,387 133%
Node First Choice Occunet $17,387 133%
Blue Cross Blue Shield $17,650 135%
Advanced Health Systems $17,990 137%
Molina Exchange $19,349 148%
Node First Choice Seven Corners $19,706 150%
Magnolia Exchange $20,285 155%
Ms Work Comp $22,103 169%
Prime Health Wc $22,103 169%
First Choice Lgp $25,270 193%
Vantage Health Commercial $26,081 199%
Cigna $44,900 342%
Self Pay $49,638 378%
Trimed Billing Solutions $67,688 516%
Ms State Hospital Of Whitfield Ms $85,738 654%
First Choice Standard $103,789 791%
First Choice Coventry $117,326 894%
First Choice Mpcn Standard $124,095 946%
First Choice Ppo Plus $124,095 946%
Phcs $135,377 1032%
First Choice Stratose $180,502 1376%
Prime Health Services $180,502 1376%
American Health Group $191,783 1462%
Beech Street $191,783 1462%
Benefit Administration Services $191,783 1462%
Benefit Management Systems $191,783 1462%
Citizens State Bank Inc $191,783 1462%
Formost $191,783 1462%
Usa Mco $191,783 1462%
One Health Plan $203,065 1548%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1030 River Oaks Drive, Flowood, MS 39232
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals