CMS Price Transparency Data

Total hip replacement

Facility: Mary Hitchcock Memorial Hospital

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27130
Insurance Median: $6,364
Cash Discount Price: $7,845
vs. Medicare Baseline: 0.49x Medicare

The contracted insurance negotiated median rate for a Total hip replacement at Mary Hitchcock Memorial Hospital is $6,364. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,845. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.49x the Medicare baseline. Located in 1 Medical Center Drive, Lebanon, NH.

Cash / Self-Pay

$7,845

Average discount available for prompt cash payment at this facility.

Insurance Median

$6,364

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: $7,845 (60%)

Insurance Median: $6,364 (49%)

Cash: $7,845 (60% of Medicare)

Ins. Median: $6,364 (49% 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
Granite State Health Plan	$158 - $3,228	1%
Beacon Health Strategies/Carelon	$542 - $3,130	4%
Amerihealth Caritas Nh	$558 - $2,905	4%
Wellsense Health Plan	$558 - $15,119	4%
Blue Cross Blue Shield	$871 - $56,025	7%
Martin'S Point Generations Advantage	$871 - $14,399	7%
Mvp	$871 - $17,177	7%
UnitedHealthcare	$871 - $19,690	7%
Martin'S Point Health Care	$890 - $14,399	7%
Aetna	$898 - $17,998	7%
Cigna	$898 - $17,588	7%
Wellcare Health Plans	$906 - $14,975	7%
Ambetter / Centene	$915 - $30,978	7%
Harvard Pilgrim Health Care Of Ne	$937 - $28,268	7%
Mass General Brigham Health Plan	$3,706 - $15,947	28%
Tufts Health Plan	$4,017 - $14,957	31%
Maine Community Health Options	$16,331 - $18,844	125%
Coventry	$22,305	170%
First Health/Hcvm	$22,305	170%
Phcs	$23,074	176%
Corvel	$23,587	180%
Ccmsi	$24,356	186%

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 $7,845.
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 Mary Hitchcock Memorial 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.