CMS Price Transparency Data

Total hip replacement

Facility: Carolina East Medical Center

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27130
  • Insurance Median: $4,318
  • Cash Discount Price: $3,711
  • vs. Medicare Baseline: 0.33x Medicare
The contracted insurance negotiated median rate for a Total hip replacement at Carolina East Medical Center is $4,318. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,711. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.33x the Medicare baseline. Located in 2000 Neuse Blvd, New Bern, NC.
Cash / Self-Pay
$3,711

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,318

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: $3,711 (28%)
Insurance Median: $4,318 (33%)
Cash: $3,711 (28% of Medicare)
Ins. Median: $4,318 (33% 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
Humana $1,087 8%
Inclusive Health (Nchirp)-All Plans $1,087 8%
Tricare $1,087 8%
Pamlico Co Jail-All Plans $1,645 13%
Craven Co. Jail Systems - All Plans $2,146 16%
UnitedHealthcare $2,165 17%
Medcost Ppo Employees And Retirees $4,061 31%
Medcost Ppo Ultra (Employees) $4,061 31%
Blue Cross Blue Shield $4,318 33%
Medcost Ppo City Employees $4,505 34%
Medcost Ppo County Employee $4,685 36%
Benefit Mgmt, Svcs-All Plans $5,257 40%
Medcost Benefit Svc-All Other Plans $5,466 42%
Aetna $5,480 42%
Acs Consult Svc Inc-All Plans $5,586 43%
Medcost Ppo Standard $5,586 43%
Cigna $5,628 43%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2000 Neuse Blvd, New Bern, NC 28560
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals