CMS Price Transparency Data

Total hip replacement

Facility: HCA Houston Healthcare Medical Center

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27130
  • Insurance Median: $14,000
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.07x Medicare
The contracted insurance negotiated median rate for a Total hip replacement at HCA Houston Healthcare Medical Center is $14,000. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 1.07x the Medicare baseline. Located in 1313 Hermann Dr, Houston, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$14,000

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%)
Insurance Median: $14,000 (107%)
Ins. Median: $14,000 (107% 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
Superior Health Plan $948 7%
Aetna $2,428 - $4,796 19%
American Health Plan $12,000 91%
Procare Advantage $12,000 91%
Humana $14,000 - $26,130 107%
Devoted Health $16,121 123%
Shared Health $16,766 128%
Oscar $18,425 140%
United $20,741 - $30,000 158%
Curative Administrators $23,981 183%
Evry Health $24,561 187%
Blue Cross Blue Shield $31,180 - $45,699 238%
Healthcare Highways $42,583 325%
Cigna $46,937 - $60,464 358%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1313 Hermann Dr, Houston, TX 77004
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals