CMS Price Transparency Data
Total hip replacement
Facility: Coastal Communities Hospital
Billing Code: 27130 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 27130
- Insurance Median: $16,432
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.25x Medicare
The contracted insurance negotiated median rate for a Total hip replacement at Coastal Communities Hospital is $16,432. 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 1.25x the Medicare baseline. Located in 2701 S Bristol St, Santa Ana, CA.
Cash / Self-Pay
Unavailable
Average discount available for prompt cash payment at this facility.
Insurance Median
$16,432
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: $16,432 (125%)
Ins. Median: $16,432 (125% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Kpc Healthcare Inc | $1,787 - $20,641 | 14% |
| Healthcare Partners | $2,136 | 16% |
| Hollywood Presbyterian | $2,136 - $16,432 | 16% |
| Kaiser | $2,136 - $16,432 | 16% |
| Medi-Cal Hmo/Non Contract | $2,136 | 16% |
| Medicaid / KanCare | $2,136 | 16% |
| Altamed Health Services | $2,991 - $16,432 | 23% |
| Caloptima | $2,991 - $16,513 | 23% |
| Choc Health Alliance | $2,991 | 23% |
| County Of Orange | $2,991 | 23% |
| Family Choice | $2,991 | 23% |
| Heritage Provider Network | $2,991 - $5,815 | 23% |
| Prospect Health Plan | $2,991 - $24,769 | 23% |
| Aetna | $4,747 | 36% |
| Monarch | $7,637 - $16,432 | 58% |
| Cigna | $8,806 | 67% |
| Monarch Health Plan | $9,612 | 73% |
| UnitedHealthcare | $13,439 - $16,432 | 102% |
| Ihhi Reciprocity | $15,000 | 114% |
| Blue Shield | $16,432 - $62,605 | 125% |
| Central Health Plan Of California | $16,432 | 125% |
| Champion Health Plan | $16,432 | 125% |
| Citizens Choice Health Plan | $16,432 | 125% |
| Clever Care Health Plan | $16,432 | 125% |
| For Your Benefit | $16,432 | 125% |
| Health Net | $16,432 - $28,328 | 125% |
| Healthcare Partners Sr Hmo | $16,432 | 125% |
| Heritage | $16,432 | 125% |
| Humana | $16,432 | 125% |
| Onecare | $16,432 | 125% |
| Onecare Connect | $16,432 | 125% |
| Other Senior Non Contract | $16,432 | 125% |
| Scan Health Plan | $16,432 | 125% |
| Us Federal Marshall/Department Of Immigration | $16,432 | 125% |
| Velocity Provider Network Sr | $16,432 | 125% |
| Verda Health Plan Sr | $16,432 | 125% |
| Veterans Administration | $16,432 | 125% |
| Choice Physicians Network | $16,513 | 126% |
| Easy Choice Health Plan | $16,513 | 126% |
| Imperial Health Plan Of Ca | $16,513 | 126% |
| Innovative Integrated Health | $16,513 | 126% |
| Medcare Partners | $16,513 | 126% |
| Self Pay Ab774/Cbo Use Only | $16,513 | 126% |
| Us Dept Of Labor | $16,513 | 126% |
| Victim Of Violent Crime | $16,513 | 126% |
| Victoria Hospice | $16,513 | 126% |
| Brand New Day | $18,404 | 140% |
| Prime Health Srvs | $18,897 | 144% |
| Coventry Auto Network | $19,765 | 151% |
| Prime Health Srvs/Wc | $19,765 | 151% |
| Interplan | $19,985 | 152% |
| Coventry Wc | $20,534 | 157% |
| County Of Orange/Custody/Advanced Medmgt | $20,540 | 157% |
| Veterans Evaluation Services | $20,641 | 157% |
| Multiplan | $21,522 - $35,000 | 164% |
| Three Rivers | $21,522 | 164% |
| Velocity National Provider Network Wc | $21,962 | 167% |
| Workers Comp State Of California | $21,962 | 167% |
| Staywell/Island Home Ins | $23,118 | 176% |
| Three Rivers Network | $28,897 | 220% |
| Velocity National Provider Network Ppo | $28,897 | 220% |
| Healthsmart | $37,500 | 286% |
| Champus | $50,000 | 381% |