CMS Price Transparency Data

Total hip replacement

Facility: Santa Monica - UCLA Med Ctr & Orthopaedic Hospital

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27130
  • Insurance Median: $16,589
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.26x Medicare
The contracted insurance negotiated median rate for a Total hip replacement at Santa Monica - UCLA Med Ctr & Orthopaedic Hospital is $16,589. 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 1.26x the Medicare baseline. Located in 1250 16Th Street, Santa Monica, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$16,589

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: $16,589 (126%)
Ins. Median: $16,589 (126% 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 Shield $5,997 - $16,349 46%
Blue Cross Blue Shield $13,417 - $19,989 102%
La Care Dsnp $16,349 125%
Monarch $16,349 125%
UnitedHealthcare $16,349 - $47,391 125%
Aetna $16,513 126%
Medicare (plans) $16,513 - $17,983 126%
St. Jude $16,513 126%
Triwest Healthcare Alliance $16,513 126%
Providence Healthcare $17,983 137%
Central Health Plan $19,733 150%
Healthsmart $19,815 151%
Scan $22,071 168%
La Care Covered Ca $23,022 176%
Centivo $39,630 302%
Health Plan Of Nevada Commercial $45,999 351%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1250 16Th Street, Santa Monica, CA 90404
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals