CMS Price Transparency Data

Total hip replacement

Facility: S E Lackey Memorial Hospital

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27130
Insurance Median: $4,229
Cash Discount Price: $7,297
vs. Medicare Baseline: 0.32x Medicare

The contracted insurance negotiated median rate for a Total hip replacement at S E Lackey Memorial Hospital is $4,229. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,297. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.32x the Medicare baseline. Located in 330 N Broad Street, Forest, MS.

Cash / Self-Pay

$7,297

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,229

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: $7,297 (56%)

Insurance Median: $4,229 (32%)

Cash: $7,297 (56% of Medicare)

Ins. Median: $4,229 (32% 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	$500	4%
UnitedHealthcare	$912 - $7,559	7%
Magnolia Mcr Adv	$1,073 - $4,229	8%
Va Ccn - All Plans	$1,073 - $4,229	8%
Wellcare Mcr Adv - All Plans	$1,073 - $4,229	8%
Corvel - All Plans	$4,072 - $9,062	31%
Magnolia Comm/Exch - All Other Plans	$4,229	32%
Cigna	$6,041	46%
Blue Cross Blue Shield	$7,552 - $22,527	58%
Magnolia Mcaid	$7,559	58%
First/Health Choice - All Plans	$8,055	61%
Health Partners - All Plans	$8,357	64%
Multiplan - All Plans	$9,062	69%

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 $7,297.
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 S E Lackey Memorial Hospital 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.