CMS Price Transparency Data

Total hip replacement

Facility: Emerson Hospital -

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27130
Insurance Median: $13,159
Cash Discount Price: $24,385
vs. Medicare Baseline: 1.00x Medicare

The contracted insurance negotiated median rate for a Total hip replacement at Emerson Hospital - is $13,159. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $24,385. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 1.00x the Medicare baseline. Located in 133 Old Road To 9 Acre Corner, W Concord, MA.

Cash / Self-Pay

$24,385

Average discount available for prompt cash payment at this facility.

Insurance Median

$13,159

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: $24,385 (186%)

Insurance Median: $13,159 (100%)

Cash: $24,385 (186% of Medicare)

Ins. Median: $13,159 (100% 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	$3,251	25%
Blue Cross Blue Shield	$13,117 - $14,561	100%
Medicaid / KanCare	$13,117	100%
Medicare (plans)	$13,117	100%
Tufts Senior Care Options	$13,117	100%
UnitedHealthcare	$13,117 - $24,385	100%
Tufts Ppo	$17,790	136%
Wellpoint (Formerly Unicare)	$17,882	136%
Cigna	$23,800	181%

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 $24,385.
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 Emerson 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.