CMS Price Transparency Data

Total hip replacement

Facility: Regional West Medical Center

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27130
Insurance Median: $13,998
Cash Discount Price: $19,300
vs. Medicare Baseline: 1.07x Medicare

The contracted insurance negotiated median rate for a Total hip replacement at Regional West Medical Center is $13,998. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $19,300. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 1.07x the Medicare baseline. Located in 4021 Ave B, Scottsbluff, NE.

Cash / Self-Pay

$19,300

Average discount available for prompt cash payment at this facility.

Insurance Median

$13,998

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: $19,300 (147%)

Insurance Median: $13,998 (107%)

Cash: $19,300 (147% of Medicare)

Ins. Median: $13,998 (107% 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	$1,048 - $29,915	8%
Humana	$1,048 - $13,332	8%
Medica	$1,048 - $27,342	8%
Medica Cost	$1,100 - $13,998	8%
Wellcare	$1,100 - $13,998	8%
Naphcare	$1,572 - $19,997	12%
Winhealth	$1,991 - $27,342	15%
Blue Cross Blue Shield	$2,325 - $25,734	18%
UnitedHealthcare	$2,384 - $28,950	18%
Ambetter / Centene	$2,469 - $19,997	19%
Cigna	$2,995 - $28,950	23%
Rci Insurance Group	$2,995 - $27,020	23%

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 $19,300.
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 Regional West 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.