CMS Price Transparency Data

Total hip replacement

Facility: Physicians Regional Medical Center

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27130
  • Insurance Median: $11,679
  • Cash Discount Price: $14,428
  • vs. Medicare Baseline: 0.89x Medicare
The contracted insurance negotiated median rate for a Total hip replacement at Physicians Regional Medical Center is $11,679. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $14,428. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.89x the Medicare baseline. Located in 7565 Dannaher Way Powell, Powell, TN.
Cash / Self-Pay
$14,428

Average discount available for prompt cash payment at this facility.

Insurance Median
$11,679

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: $14,428 (110%)
Insurance Median: $11,679 (89%)
Cash: $14,428 (110% of Medicare)
Ins. Median: $11,679 (89% 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
Blue Cross Blue Shield $994 - $14,605 8%
Veterans Eval Services $1,149 9%
Aetna $3,435 - $11,793 26%
Medicaid / KanCare $6,606 50%
UnitedHealthcare $6,606 - $64,444 50%
Humana $11,450 87%
Medicare (plans) $11,450 87%
Node Bluecare Plus Tn Mcr Adv $11,450 - $11,648 87%
Node Hospice Non Par Agree $11,648 89%
Node Va $11,648 89%
Node Devoted Health Mcr Adv $11,679 89%
Node Farm Bureau Mcr Adv $11,679 89%
Node Healthspring Mcr Adv $11,793 90%
Amerigroup $12,022 92%
Wellcare $12,114 92%
Node Nhc Mcr Adv $12,595 96%
Self Pay $14,260 - $14,597 109%
Node Us Dept Of Labor $14,560 111%
Us Department Of Labor $14,560 111%
Novanet Work Comp Tn $19,107 146%
Occunet Work Comp Tn $19,300 147%
Tn Work Comp $19,300 147%
Ambetter / Centene $21,549 164%
Node Point Comfort Underwriters $21,549 164%
Cigna $26,866 - $27,018 205%
Multiplan $34,800 - $46,528 265%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7565 Dannaher Way Powell, Powell, TN 37849
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals