CMS Price Transparency Data

Total hip replacement

Facility: Cheshire Medical Center

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27130
Insurance Median: $8,818
Cash Discount Price: $4,060
vs. Medicare Baseline: 0.67x Medicare

The contracted insurance negotiated median rate for a Total hip replacement at Cheshire Medical Center is $8,818. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,060. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.67x the Medicare baseline. Located in 580 Court Street, Keene, NH.

Cash / Self-Pay

$4,060

Average discount available for prompt cash payment at this facility.

Insurance Median

$8,818

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: $4,060 (31%)

Insurance Median: $8,818 (67%)

Cash: $4,060 (31% of Medicare)

Ins. Median: $8,818 (67% 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	$825 - $13,444	6%
Amerihealth Caritas Nh	$904 - $1,800	7%
Granite State Health Plan	$904 - $2,457	7%
Wellsense Health Plan	$904 - $14,385	7%
Ambetter / Centene	$918 - $11,953	7%
Blue Cross Blue Shield	$918 - $43,634	7%
Cigna	$918 - $13,444	7%
Martin'S Point Generations Advantage	$918 - $13,444	7%
Martin'S Point Health Care	$918 - $13,444	7%
Mvp	$918 - $13,444	7%
UnitedHealthcare	$918 - $20,261	7%
Wellcare Health Plans	$918 - $13,444	7%
Harvard Pilgrim Health Care Of Ne	$3,133 - $15,792	24%
Tufts Health Plan	$3,518 - $9,389	27%
Maine Community Health Options	$6,620	50%
Mass General Brigham Health Plan	$11,162 - $14,710	85%
First Health/Hcvm	$12,504	95%
Phcs	$13,239	101%

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 $4,060.
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 Cheshire 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.