CMS Price Transparency Data

Total hip replacement

Facility: Community Medical Center

Billing Code: 27130 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$15,041
about 1.1× the $13,117 Medicare rate · typically $8,846–$19,915
modeled estimate · not a bill or quote
What this hospital charges insurers
$20,329
Above the fair price
about $5,288 over the fair price · 1.5× Medicare
Medicare pays $13,117 Fair price $15,041 This hospital $20,329 Cash price $3,786

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 $20,329

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 $15,041 (about 1.1× the $13,117 Medicare rate). Community Medical Center charges insurers about $20,329, or about $3,786 in cash — above the fair price. Located in Toms River, NJ.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $15,041. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

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 $14,343 - $26,500 109%
Blue Cross Blue Shieldmajor $3,266 - $14,062 25%
Aetnamajor $14,062 - $26,240 107%
Cignamajor $15,999 - $21,412 122%
Humanamajor $14,062 107%
AmeriHealth $21,284 - $23,943 162%
Clover Health $14,062 107%
Fidelis Care $14,062 107%
WellCare $27,983 213%
+ 2 smaller / regional plans $2,699 - $24,608

Self-Pay How to get the cash price

Insurance Before you use insurance

Estimate your out-of-pocket cost

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

Enter your details and press estimate to compare.

Facility Profile & Credentials

  • Address: 99 Rt 37 West, Toms River, NJ 08755
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals