CMS Price Transparency Data

Total hip replacement

Facility: Goshen Hospital

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27130
  • Insurance Median: $12,409
  • Cash Discount Price: $41,272
  • vs. Medicare Baseline: 0.95x Medicare
The contracted insurance negotiated median rate for a Total hip replacement at Goshen Hospital is $12,409. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $41,272. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.95x the Medicare baseline. Located in 200 High Park Ave, Goshen, IN.
Cash / Self-Pay
$41,272

Average discount available for prompt cash payment at this facility.

Insurance Median
$12,409

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: $41,272 (315%)
Insurance Median: $12,409 (95%)
Cash: $41,272 (315% of Medicare)
Ins. Median: $12,409 (95% 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
Advantage Health Solutions $12,409 95%
Aetna $12,409 95%
Atrio Health Plans $12,409 95%
Bc Federal Employee $12,409 95%
Bc Mcr Advantage Ppo $12,409 95%
Blue Cross Blue Shield $12,409 95%
Buckeye Health Plan $12,409 95%
Cigna $12,409 95%
Coventry Health And Life $12,409 95%
Emblem Health $12,409 95%
Freedom Healthcare $12,409 95%
Geisinger Health Plan $12,409 95%
Health First $12,409 95%
Healthspring $12,409 95%
Humana $12,409 95%
Iehp Empire Health Plan $12,409 95%
Independent Care Health Plan $12,409 95%
Kaiser Permanente $12,409 95%
Mcr Advantra Freedom $12,409 95%
Mcr Allwell Mhs $12,409 95%
Mcr Banner Health $12,409 95%
Mcr Complete $12,409 95%
Mcr Complete Ppo $12,409 95%
Mcr Complete Wellmed $12,409 95%
Mcr Health Alliance $12,409 95%
Mcr Health Partners Plans $12,409 95%
Mcr Medical Mutual Of Ohio $12,409 95%
Mcr Passport Advantage $12,409 95%
Mcr Secure Horizons Ppo $12,409 95%
Mcr Texan Plus $12,409 95%
Mcr Upmc For Life $12,409 95%
Medicare (plans) $12,409 - $13,153 95%
Meridian Complete $12,409 95%
Optimum Healthcare $12,409 95%
Paramount Elite $12,409 95%
Primetime Health Plan $12,409 95%
Simply Complete Hmo $12,409 95%
The Umwa H&R Funds $12,409 95%
Todays Options Pyramid Life $12,409 95%
Trillium Advantage $12,409 95%
Ucare For Seniors $12,409 95%
Ucare Minnesota $12,409 95%
UnitedHealthcare $12,409 95%
Wellcare $12,409 95%
Champva $12,770 97%
Tricare $12,770 97%
Mcr Devoted Health Plan $13,153 100%
Mcr Provider Partners Hlth Pln $14,047 107%
Ambetter / Centene $17,878 136%
Mkt Caresource $17,878 136%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 200 High Park Ave, Goshen, IN 46526
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals