CMS Price Transparency Data

Total hip replacement

Facility: Watsonville Community Hospital

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27130
Insurance Median: $2,136
Cash Discount Price: $5,027
vs. Medicare Baseline: 0.16x Medicare

The contracted insurance negotiated median rate for a Total hip replacement at Watsonville Community Hospital is $2,136. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,027. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.16x the Medicare baseline. Located in 75 Nielson Street, Watsonville, CA.

Cash / Self-Pay

$5,027

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,136

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: $5,027 (38%)

Insurance Median: $2,136 (16%)

Cash: $5,027 (38% of Medicare)

Ins. Median: $2,136 (16% 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
California Childrens Srvs	$1,878 - $2,136	14%
Ccs/Monterey County	$1,878 - $2,136	14%
Healthy Families	$1,878 - $2,136	14%
Medi-Cal E.R.	$1,878 - $2,136	14%
Medi-Cal/Eds	$1,878 - $2,136	14%
Medicaid / KanCare	$1,878 - $2,136	14%
Well Path	$1,878 - $2,136	14%
Alliance/Sccho	$2,755 - $3,662	21%
Aetna	$9,187	70%
Blue Cross Blue Shield	$11,478	88%
Calif Ironworkers Field	$11,478	88%
Carpenters H&W Trust	$11,478	88%
City Of Wats/Pinnacle Clm	$11,478	88%
Claims Management Wc	$11,478	88%
Delta Health Systems	$11,478	88%
Laborers Health & Welfare	$11,478	88%
Monterey Bay Pub Emp Trst	$11,478	88%
Operating Engineers	$11,478	88%
Pinnacle Claims Tpa/Bc	$11,478	88%
Robert Kennedy/Ccn	$11,478	88%
Sheet Metal Workers	$11,478	88%
State Compensation Fund	$11,478	88%
Teamsters Benefit Trust	$11,478	88%
Western Growers Trust/Bc	$11,478	88%

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 $5,027.
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 Watsonville Community Hospital 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.