CMS Price Transparency Data

Total hip replacement

Facility: Riverview Medical Center

Billing Code: 27130 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$15,538

about 1.2× the $13,117 Medicare rate · typically $11,036–$21,407

modeled estimate · not a bill or quote

What this hospital charges insurers

$14,240

About the fair price

about $1,298 under the fair price · 1.1× Medicare

Medicare pays $13,117 Fair price $15,538 This hospital $14,240 Cash price $14,242 Hospital's list price $16,225

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 $14,240

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 $15,538 (about 1.2× the $13,117 Medicare rate). Riverview Medical Center charges insurers about $14,240, or about $14,242 in cash — about the fair price. Located in Red Bank, NJ.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser 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	$2,379 - $27,151	18%
Blue Cross Blue Shieldmajor	$3,537 - $14,242	27%
Aetnamajor	$2,288 - $15,524	17%
Cignamajor	$12,980 - $14,240	99%
AmeriHealth	$13,972 - $15,795	107%
Clover Health	$2,920	22%
WellCare	$14,242	109%
+ 8 smaller / regional plans	$1,892 - $21,748

Government programs also on file: Military & VA.

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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 14,242), 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 Riverview Medical Center 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 Riverview Medical Center

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.