CMS Price Transparency Data

Total hip replacement

Facility: Covenant Medical Center

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27130
Insurance Median: $1,997
Cash Discount Price: $2,541
vs. Medicare Baseline: 0.15x Medicare

The contracted insurance negotiated median rate for a Total hip replacement at Covenant Medical Center is $1,997. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,541. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.15x the Medicare baseline. Located in 1447 N Harrison, Saginaw, MI.

Cash / Self-Pay

$2,541

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,997

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: $2,541 (19%)

Insurance Median: $1,997 (15%)

Cash: $2,541 (19% of Medicare)

Ins. Median: $1,997 (15% 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
Health Advantage Mclaren Employee	$1,089 - $1,634	8%
Priority Health E	$1,113 - $1,670	8%
Aetna	$1,145 - $13,117	9%
Blue Cross Blue Shield	$1,145 - $21,144	9%
Health Alliance Plan Of Michigan	$1,145 - $25,315	9%
Healthy Michigan Mclaren	$1,145 - $6,860	9%
Healthy Michigan Meridian	$1,145 - $6,860	9%
Healthy Michigan Molina	$1,145 - $6,860	9%
Healthy Michigan Priority Health	$1,145 - $6,860	9%
Humana	$1,145 - $13,117	9%
Mclaren Advantage	$1,145 - $13,117	9%
Molina Healthplan	$1,145 - $13,117	9%
Physicians Health Plan Advantage/Advantage Plus	$1,145 - $13,117	9%
Priority Health	$1,145 - $13,117	9%
Physicians Health Plan	$1,331 - $1,996	10%
Meritain Health	$1,851 - $2,777	14%
Mclaren Health Advantage	$1,898 - $2,847	14%
Multiplan	$2,178 - $3,267	17%
Blue Care Network	$2,278 - $21,144	17%

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 $2,541.
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 Covenant Medical Center 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.