CMS Price Transparency Data

Total hip replacement

Facility: Alice Peck Day Memorial Hospital

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27130
Insurance Median: $3,083
Cash Discount Price: $2,169
vs. Medicare Baseline: 0.24x Medicare

The contracted insurance negotiated median rate for a Total hip replacement at Alice Peck Day Memorial Hospital is $3,083. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,169. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.24x the Medicare baseline. Located in 10 Alice Peck Day Drive, Lebanon, NH.

Cash / Self-Pay

$2,169

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,083

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: $2,169 (17%)

Insurance Median: $3,083 (24%)

Cash: $2,169 (17% of Medicare)

Ins. Median: $3,083 (24% 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
Ambetter / Centene	$850	6%
Nh Healthy Families	$884	7%
Medicaid / KanCare	$1,847	14%
Blue Cross Blue Shield	$1,990 - $3,582	15%
Harvard Pilgrim	$2,504 - $3,490	19%
UnitedHealthcare	$2,898	22%
Tufts	$2,952	23%
Cigna	$3,083 - $3,292	24%
Commercial Generic	$3,083	24%
Connecticut General	$3,083	24%
Klais	$3,111	24%
Wellpoint	$3,164	24%
Aetna	$3,622	28%
Mvp	$3,663	28%
Coventry Health	$3,824	29%
Coventry Health Wc	$3,824	29%
Humana	$4,186	32%

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 $2,169.
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 Alice Peck Day 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.