CMS Price Transparency Data

Total hip replacement

Facility: Cleveland Clinic Martin North Hospital

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27130
Insurance Median: $2,027
Cash Discount Price: $5,479
vs. Medicare Baseline: 0.15x Medicare

The contracted insurance negotiated median rate for a Total hip replacement at Cleveland Clinic Martin North Hospital is $2,027. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,479. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.15x the Medicare baseline. Located in 200 Se Hospital Ave, Stuart, FL.

Cash / Self-Pay

$5,479

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,027

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: $5,479 (42%)

Insurance Median: $2,027 (15%)

Cash: $5,479 (42% of Medicare)

Ins. Median: $2,027 (15% 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
Freedom Health	$994 - $13,561	8%
Amerihealth	$1,024	8%
Miami Childrens Health Plan	$1,044 - $12,915	8%
Molina	$1,044	8%
Sunshine Health	$1,044	8%
Blue Cross Blue Shield	$1,137 - $12,915	9%
Independent Living Systems	$1,193 - $1,426	9%
Avmed	$1,358 - $49,725	10%
United	$1,358 - $28,910	10%
Careplus	$1,426 - $13,561	11%
Clear Spring Health	$1,466	11%
Aetna	$1,569 - $12,915	12%
Cigna	$1,902 - $2,440	15%
Multiplan	$2,036	16%
Clarity Health	$5,479	42%
The Legacy Companies	$5,479	42%
Consociate Health	$6,322	48%
Humana	$12,915	98%
Wellcare	$12,915	98%
Devoted Health	$14,207	108%

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 $5,479.
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 Cleveland Clinic Martin North 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.