CMS Price Transparency Data

Total hip replacement

Facility: Physicians Regional Medical Center

Billing Code: 27130 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$10,839

about 0.8× the $13,117 Medicare rate · typically $4,714–$12,399

modeled estimate · not a bill or quote

What this hospital charges insurers

$11,793

About the fair price

about $954 over the fair price · 0.9× Medicare

Medicare pays $13,117 Fair price $10,839 This hospital $11,793 Cash price $14,428 Hospital's list price $64,988

How we calculate the fair BaseRate →

How this hospital compares to other TN hospitals

Highest price of the 9 TN hospitals we have prices for — worth calling around.

Cheapest $3,449 Priciest $11,793

Black dot = this hospital, among the 9 TN hospitals with a price for this procedure. Full list below.

A fair price for a Total hip replacement is about $10,839 (about 0.8× the $13,117 Medicare rate). Physicians Regional Medical Center charges insurers about $11,793, or about $14,428 in cash — about the fair price. Located in Powell, TN.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$6,606 - $64,444	50%
Blue Cross Blue Shieldmajor	$994 - $14,605	8%
Aetnamajor	$3,435 - $11,793	26%
Cignamajor	$26,866 - $27,018	205%
Humanamajor	$11,450	87%
Ambetter (Centene)	$21,549	164%
Amerigroup	$12,022	92%
Cigna HealthSpring	$11,793	90%
Devoted Health	$11,679	89%
WellCare	$12,114	92%
+ 7 smaller / regional plans	$11,450 - $21,549

Government programs also on file: Medicare, Medicaid, Military & VA.

Excludes 4 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 14,428), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 27130.

Insurance Before you use insurance

Call your insurance company to confirm Physicians Regional Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 27130.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Physicians Regional Medical Center

Compare: Total hip replacement at other TN hospitals

Insurance negotiated median for the same procedure, sorted lowest first.