CMS Price Transparency Data

Total hip replacement

Facility: St Mary's General Hospital

Billing Code: 27130 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$16,035

about 1.2× the $13,117 Medicare rate · typically $10,415–$21,426

modeled estimate · not a bill or quote

What this hospital charges insurers

$15,178

About the fair price

about $857 under the fair price · 1.2× Medicare

Medicare pays $13,117 Fair price $16,035 This hospital $15,178 Cash price $15,177 Hospital's list price $63,740

How we calculate the fair BaseRate →

How this hospital compares to other NJ hospitals

Highest price of the 9 NJ hospitals we have prices for — worth calling around.

Cheapest $9,176 Priciest $15,178

Black dot = this hospital, among the 9 NJ hospitals with a price for this procedure. Full list below.

A fair price for a Total hip replacement is about $16,035 (about 1.2× the $13,117 Medicare rate). St Mary's General Hospital charges insurers about $15,178, or about $15,177 in cash — about the fair price. Located in Passaic, NJ.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$6,317 - $15,178	48%
Blue Cross Blue Shieldmajor	$15,178	116%
Aetnamajor	$15,178 - $32,177	116%
Cignamajor	$22,304	170%
Humanamajor	$12,142	93%
AmeriHealth	$15,178	116%
Clover Health	$15,178	116%
WellCare	$15,178 - $20,490	116%
+ 5 smaller / regional plans	$1,715 - $26,911

Government programs also on file: Medicare, Military & VA.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 15,177), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 27130.

Insurance Before you use insurance

Call your insurance company to confirm St Mary's General Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 27130.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at St Mary's General Hospital

Compare: Total hip replacement at other NJ hospitals

Raritan Bay Medical Center · Perth Amboy $9,176
Jefferson Stratford Hospital · Stratford $10,746
Ocean Medical Center · Brick $12,867
Jfk University Medical Center · Edison $12,867
Cape Regional Medical Center Inc · Cape May Court House $14,002
Capital Health Regional Medical Center · Trenton $14,062
Southern Ocean Medical Center · Manahawkin $14,062
Bayshore Medical Center · Holmdel $14,231

Insurance negotiated median for the same procedure, sorted lowest first.