CMS Price Transparency Data

Total hip replacement

Facility: Gibson General Hospital

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27130
Insurance Median: $1,616
Cash Discount Price: $2,155
vs. Medicare Baseline: 0.12x Medicare

The contracted insurance negotiated median rate for a Total hip replacement at Gibson General Hospital is $1,616. 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 0.12x the Medicare baseline. Located in 1808 Sherman Drive, Princeton, IN.

Cash / Self-Pay

$2,155

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,616

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: $1,616 (12%)

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

Ins. Median: $1,616 (12% 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
Aetna	$1,154 - $4,055	9%
Blue Cross Blue Shield	$1,154 - $1,975	9%
Caresource Just For Me	$1,154	9%
Medicare (plans)	$1,154	9%
Meridiancomplete (Il)	$1,154	9%
Mytruadvantage	$1,154	9%
UnitedHealthcare	$1,154 - $2,373	9%
Va Ccn	$1,154	9%
Caresource	$1,159	9%
Mdwise Plans	$1,159	9%
Mhs	$1,159	9%
Medicaid / KanCare	$1,272	10%
Meridiancare (Il)	$1,272	10%
Meridianhealth (Il)	$1,272	10%
Ambetter / Centene	$1,443	11%
Caresource In Marketplace	$1,500	11%
Alliance Coal	$1,616	12%
Claimdoc	$1,616	12%
Hopetrust	$1,731	13%
Hstechnology	$1,731	13%
Encircle/Encore Combined	$1,826	14%
Encircle/Encore Prime	$1,826	14%
Noncontracted	$1,847	14%
Deaconess Onecare	$1,904 - $28,435	15%
Ky Racing Health & Welfare Fund	$2,155	16%
Self-Pay	$2,155	16%
Chambercare	$3,694	28%
Cigna	$4,055	31%
First Health	$4,055	31%
Healthlink Hmo	$4,055	31%
Healthlink Ppo	$4,055	31%
Sagamore (Ppo, Oap-Open Access Plus, Epo, Choice Fund Oap+)	$4,055	31%
Gibson County Sheriff	$5,233	40%
Integrated Health	$5,541	42%
Principal Health Care	$5,541	42%

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 Gibson General 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.