CMS Price Transparency Data

Total hip replacement

Facility: Raritan Bay Medical Center

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27130
  • Insurance Median: $8,934
  • Cash Discount Price: $14,254
  • vs. Medicare Baseline: 0.68x Medicare
The contracted insurance negotiated median rate for a Total hip replacement at Raritan Bay Medical Center is $8,934. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $14,254. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.68x the Medicare baseline. Located in 530 New Brunswick Ave, Perth Amboy, NJ.
Cash / Self-Pay
$14,254

Average discount available for prompt cash payment at this facility.

Insurance Median
$8,934

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: $14,254 (109%)
Insurance Median: $8,934 (68%)
Cash: $14,254 (109% of Medicare)
Ins. Median: $8,934 (68% 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.

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
Horizon $2,112 - $9,102 16%
Aetna $2,158 - $15,537 16%
UnitedHealthcare $2,379 - $26,906 18%
Karna $2,746 21%
Activecare First McO $2,915 22%
Clover $2,920 22%
Seoul Medical Group $3,359 26%
Qualcare $5,366 - $9,347 41%
Amerihealth $5,824 - $6,508 44%
Brighton Health Plan $9,933 76%
Bergen Risk $12,169 93%
Cigna $12,980 - $14,201 99%
Multiplan - PHCS $13,791 105%
Wellcare $14,254 109%
Blue Cross Blue Shield $14,254 109%
Vaccn $14,254 109%
United Community/Americhoice $14,967 114%
Amerigroup $15,252 116%
Oxford $21,268 162%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 530 New Brunswick Ave, Perth Amboy, NJ 08861
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals