CMS Price Transparency Data

Total hip replacement

Facility: Robert Wood Johnson University Hospital - Somerset

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27130
  • Insurance Median: $16,865
  • Cash Discount Price: $6,311
  • vs. Medicare Baseline: 1.29x Medicare
The contracted insurance negotiated median rate for a Total hip replacement at Robert Wood Johnson University Hospital - Somerset is $16,865. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,311. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 1.29x the Medicare baseline. Located in 110 Rehill Ave, Somerville, NJ.
Cash / Self-Pay
$6,311

Average discount available for prompt cash payment at this facility.

Insurance Median
$16,865

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: $6,311 (48%)
Insurance Median: $16,865 (129%)
Cash: $6,311 (48% of Medicare)
Ins. Median: $16,865 (129% 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
Wellpoint $694 - $14,062 5%
Blue Cross Blue Shield $7,387 - $14,062 56%
Qualcare Inc $9,057 69%
Clover Health $14,062 107%
Fidelis Care $14,062 107%
Humana $14,062 107%
Aetna $14,062 - $26,240 107%
UnitedHealthcare $14,343 - $21,512 109%
Cigna $16,448 - $22,013 125%
Amerihealth $21,303 - $23,966 162%
Emblem Health $24,608 188%
Wellcare $27,983 213%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 110 Rehill Ave, Somerville, NJ 08876
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals