CMS Price Transparency Data

Total hip replacement

Facility: Dallas Regional Medical Center

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27130
Insurance Median: $13,476
Cash Discount Price: $12,833
vs. Medicare Baseline: 1.03x Medicare

The contracted insurance negotiated median rate for a Total hip replacement at Dallas Regional Medical Center is $13,476. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $12,833. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 1.03x the Medicare baseline. Located in 1011 North Galloway Avenue, Mesquite, TX.

Cash / Self-Pay

$12,833

Average discount available for prompt cash payment at this facility.

Insurance Median

$13,476

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: $12,833 (98%)

Insurance Median: $13,476 (103%)

Cash: $12,833 (98% of Medicare)

Ins. Median: $13,476 (103% 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.

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
Aetna	$1,900 - $19,251	14%
UnitedHealthcare	$8,231 - $12,834	63%
Careworks Fka (Rockport Community Network) Workercomp	$12,192	93%
Blue Cross Blue Shield	$12,449 - $26,777	95%
Care N Care Insurance Company	$12,834	98%
Cigna	$12,834 - $13,219	98%
Medicare (plans)	$12,834	98%
Superior Health Plan/Wellcare	$12,834 - $16,684	98%
Texas Bluebonnett Health Plan	$12,834 - $21,176	98%
Tricare	$12,834	98%
Usa Senior Care Network	$12,834	98%
Wellmed	$12,834	98%
Wellpoint Amerigroup	$12,834	98%
Molina	$13,476	103%
Multiplan	$13,476	103%
Provider Partners Health Plan	$13,476	103%
Imperial Insurance Companies Mcr	$13,604	104%
American Health Plan	$14,117	108%
Hi Card	$16,042	122%
Worker Compensation	$16,684 - $25,668	127%
American Correction Healthcare	$17,711	135%
Employee Direct Healthcare	$17,968	137%
Total Plans Srvices	$17,968	137%
Wellpath	$18,609	142%
Corporate Remedies Workers Comp	$19,251	147%
Naphcare -Prison	$19,893	152%
Elap Services	$21,176	161%

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 $12,833.
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 Dallas Regional 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.