CMS Price Transparency Data

Total hip replacement

Facility: The Women's Hospital

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27130
Insurance Median: $1,875
Cash Discount Price: $2,155
vs. Medicare Baseline: 0.14x Medicare

The contracted insurance negotiated median rate for a Total hip replacement at The Women's Hospital is $1,875. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,155. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.14x the Medicare baseline. Located in 4199 Gateway Blvd, Newburgh, IN.

Cash / Self-Pay

$2,155

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,875

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: $2,155 (16%)

Insurance Median: $1,875 (14%)

Cash: $2,155 (16% of Medicare)

Ins. Median: $1,875 (14% 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
Blue Cross Blue Shield	$1,154 - $42,970	9%
Caresource	$1,154 - $11,731	9%
Humana	$1,154 - $11,731	9%
Iu Health	$1,154 - $11,731	9%
Meridian Health Il	$1,154 - $11,731	9%
Mhs	$1,154 - $11,731	9%
Molina Il	$1,154 - $11,731	9%
Molina Ky	$1,154 - $11,731	9%
Molina Ky Dual	$1,154 - $11,731	9%
UnitedHealthcare	$1,154 - $14,882	9%
Wellcare Ky	$1,154 - $11,731	9%
Caresource Hip	$1,159	9%
Caresource In	$1,159	9%
Mdwise Hip	$1,159	9%
Mhs Behavioral	$1,159	9%
Aetna	$1,272 - $4,055	10%
Passport Molina Ky	$1,301	10%
Ambetter / Centene	$1,327 - $18,184	10%
Immergrun	$1,390 - $14,078	11%
Caresource Marketplace (Just4Me)	$1,500 - $17,597	11%
Hst	$1,558 - $17,597	12%
Alliance Coal	$1,593	12%
Allied National/Zelis - Freedom Plan	$1,616 - $28,742	12%
Claimdoc	$1,673 - $17,010	13%
Patoka Valley Health Care (80/20 Plan)	$1,731	13%
Patoka Valley Health Care (90/10 Plan)	$1,731	13%
Encorecombined	$1,826	14%
Encoreprime	$1,826	14%
Hope Trust	$1,847 - $19,357	14%
Noncontracted	$1,847 - $18,770	14%
One Care	$1,904	15%
Chamber Care	$1,912	15%
Amish	$2,155 - $4,693	16%
Self Pay	$2,155	16%
Center Care	$3,694	28%
Cigna	$4,055	31%
Claritev (Formerly Phcs/Mulitplan)	$4,055	31%
First Health/Coventry	$4,055	31%
Healthlink	$4,055	31%
Sagamore	$4,055	31%

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 $2,155.
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 The Women's 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.