CMS Price Transparency Data

Total hip replacement

Facility: Phelps Memorial Health Center

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27130
Insurance Median: $1,265
Cash Discount Price: $3,076
vs. Medicare Baseline: 0.10x Medicare

The contracted insurance negotiated median rate for a Total hip replacement at Phelps Memorial Health Center is $1,265. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,076. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.10x the Medicare baseline. Located in 1215 Tibbals St, Holdrege, NE.

Cash / Self-Pay

$3,076

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,265

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: $3,076 (23%)

Insurance Median: $1,265 (10%)

Cash: $3,076 (23% of Medicare)

Ins. Median: $1,265 (10% 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
First Health - All Plans	$1,040 - $5,460	8%
Blue Cross Blue Shield	$1,048 - $1,865	8%
Good Samaritan Mcr Adv - All Plans	$1,048	8%
Medica Mcr Adv	$1,048	8%
UnitedHealthcare	$1,048 - $5,741	8%
Va Ccn - All Plans	$1,048	8%
Wellcare Mcr Adv - All Plans	$1,048	8%
Aetna	$1,094 - $5,741	8%
Molina Mcaid - All Plans	$1,094 - $5,741	8%
Three Rivers - All Plans	$1,258	10%
Providrs Care/Wppa - All Plans	$1,269	10%
Provider Network Of American - All Plans	$1,572	12%
Partners Hlth Alliance - All Plans	$1,834	14%
6 Degrees Hlth - All Plans	$1,886	14%
Medica-All Other Plans	$1,886	14%
Midwest Ntwrk Alliance - All Plans	$1,991	15%
Ambetter / Centene	$2,015	15%

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 $3,076.
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 Phelps Memorial Health 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.