CMS Price Transparency Data

Total hip replacement

Facility: Marinhealth Medical Center

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27130
Insurance Median: $47,115
Cash Discount Price: $37,663
vs. Medicare Baseline: 3.59x Medicare

The contracted insurance negotiated median rate for a Total hip replacement at Marinhealth Medical Center is $47,115. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $37,663. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 3.59x the Medicare baseline. Located in 250 Bon Air Road, Greenbrae, CA.

Cash / Self-Pay

$37,663

Average discount available for prompt cash payment at this facility.

Insurance Median

$47,115

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: $37,663 (287%)

Insurance Median: $47,115 (359%)

Cash: $37,663 (287% of Medicare)

Ins. Median: $47,115 (359% 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 359% of the Medicare baseline (a markup of 259%). 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
UnitedHealthcare	$2,330	18%
Aetna	$18,121 - $20,733	138%
Brown And Tolan	$18,121	138%
Healthnet Tailored Network	$18,121	138%
Kaiser	$18,121	138%
Marin Cancer Care	$18,121	138%
Ca Prison Health Care Services	$28,994	221%
Blue Cross Blue Shield	$33,052 - $41,789	252%
Healthnet Enhancedcare	$47,115	359%
Provider Network Of America	$86,075	656%
Canopy	$104,196	794%
Canopy Hill Physicians	$104,196	794%
Blue Shield Cpic/Epo	$107,476	819%
Providers Network Of America	$114,162	870%
Blue Shield Hmo/Ppo	$119,418	910%
Hills Blue Shield Hmo/Ppo	$119,418	910%
Healthnet Hmo/Ppo	$120,867	921%
Healthnet Hmo/Ppo Hill Physicians	$120,867	921%
Blue Shield Aco	$123,785	944%

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 $37,663.
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 Marinhealth 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.