CMS Price Transparency Data

Total hip replacement

Facility: Glen Rose Medical Center

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27130
Insurance Median: $30,501
Cash Discount Price: $43,573
vs. Medicare Baseline: 2.33x Medicare

The contracted insurance negotiated median rate for a Total hip replacement at Glen Rose Medical Center is $30,501. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $43,573. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 2.33x the Medicare baseline. Located in 1021 Holden Street, Glen Rose, TX.

Cash / Self-Pay

$43,573

Average discount available for prompt cash payment at this facility.

Insurance Median

$30,501

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: $43,573 (332%)

Insurance Median: $30,501 (233%)

Cash: $43,573 (332% of Medicare)

Ins. Median: $30,501 (233% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 233% of the Medicare baseline (a markup of 133%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Cook Children'S	$20,044	153%
Aetna	$26,580 - $30,501	203%
Blue Cross Blue Shield	$28,322 - $34,858	216%
Rightcare Scott And White	$28,322	216%
Cigna	$30,501	233%
Scott And White	$32,680	249%
Humana	$39,216 - $41,394	299%

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 $43,573.
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 Glen Rose 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.