CMS Price Transparency Data

Total hip replacement

Facility: Carlsbad Medical Center

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27130
  • Insurance Median: $17,015
  • Cash Discount Price: $14,717
  • vs. Medicare Baseline: 1.30x Medicare
The contracted insurance negotiated median rate for a Total hip replacement at Carlsbad Medical Center is $17,015. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $14,717. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 1.30x the Medicare baseline. Located in 2430 West Pierce Street, Carlsbad, NM.
Cash / Self-Pay
$14,717

Average discount available for prompt cash payment at this facility.

Insurance Median
$17,015

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: $14,717 (112%)
Insurance Median: $17,015 (130%)
Cash: $14,717 (112% of Medicare)
Ins. Median: $17,015 (130% 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 $1,236 9%
Medicaid / KanCare $11,561 - $15,151 88%
Blue Cross Blue Shield $13,375 - $132,865 102%
Medicare (plans) $13,375 102%
Node Molina Mcr Adv $13,375 102%
Presbyterian $13,375 - $106,359 102%
Node Va $13,612 104%
Triwest $13,612 104%
Capstar $13,842 106%
UnitedHealthcare $13,910 - $75,792 106%
Node Choice Care Mcr Adv $14,043 107%
Node Devoted Health Mcr Adv $14,043 107%
Self Pay $14,717 112%
Eddy County Detention $15,000 114%
Us Department Of Labor $17,015 130%
Wexford Health $17,015 130%
Work Comp Nm $17,052 130%
Node Molina Health Exchange $37,162 283%
Nm Health Connection $54,449 415%
Cigna $73,585 - $123,328 561%
Zelis $92,717 - $123,622 707%
Omni Network $95,660 729%
Choice Care $103,019 785%
Ccn First Health $117,736 898%
Healthsmart $119,207 - $126,566 909%
Aetna $123,622 942%
Multiplan $123,622 942%
Medical Control Inc $136,868 1043%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2430 West Pierce Street, Carlsbad, NM 88220
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals