CMS Price Transparency Data

Total hip replacement

Facility: Trinity Health Oakland Hospital

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27130
  • Insurance Median: $18,811
  • Cash Discount Price: $41,062
  • vs. Medicare Baseline: 1.43x Medicare
The contracted insurance negotiated median rate for a Total hip replacement at Trinity Health Oakland Hospital is $18,811. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $41,062. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 1.43x the Medicare baseline. Located in 44405 Woodward Ave, Pontiac, MI.
Cash / Self-Pay
$41,062

Average discount available for prompt cash payment at this facility.

Insurance Median
$18,811

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: $41,062 (313%)
Insurance Median: $18,811 (143%)
Cash: $41,062 (313% of Medicare)
Ins. Median: $18,811 (143% 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
U Of M Health Plan $2,768 21%
Priority Health $3,046 - $6,770 23%
Asr Health Benefits $3,730 28%
Caresource $3,730 28%
Hap $3,730 28%
Varipro $3,730 28%
Medicaid / KanCare $7,031 - $7,171 54%
Blue Cross Blue Shield $7,171 - $23,514 55%
Aetna $12,537 96%
Blue Care Network Advantage $12,537 96%
Medicare (plans) $12,537 - $12,793 96%
Align Senior Care $12,793 98%
Hospice Advantage $12,793 98%
UnitedHealthcare $13,176 100%
Cca - Zing Health $13,540 103%
Longevity Ipa Of Michigan Llc Health Plan Isnp $14,417 110%
Molina Marketplace $16,630 127%
Bcn Domestic $18,811 - $23,514 143%
Blue Benefit Administrators Of Massachusetts $18,811 - $23,514 143%
Blue Care Network $18,811 - $23,514 143%
Blue Distinction Transplant $18,811 - $23,514 143%
Blue Shield - Ca $18,811 - $23,514 143%
Blue Shield - Id (Regence) $18,811 - $23,514 143%
Blue Shield - Ny Highmark Northeastern $18,811 - $23,514 143%
Blue Shield - Ny Highmark Western $18,811 - $23,514 143%
Blue Shield - Pa (Highmark) $18,811 - $23,514 143%
Blue Shield - Wa (Regence) $18,811 - $23,514 143%
Health Choices $18,811 - $23,514 143%
Kaiser Domestic $18,811 - $23,514 143%
Health Cost Solutions $19,828 151%
Vitalcore $19,828 151%
Wellpath $19,828 151%
Employee Benefit Logistic $29,514 225%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 44405 Woodward Ave, Pontiac, MI 48341
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals