CMS Price Transparency Data

Total hip replacement

Facility: Jersey City Medical Center

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27130
Insurance Median: $21,284
Cash Discount Price: $5,339
vs. Medicare Baseline: 1.62x Medicare

The contracted insurance negotiated median rate for a Total hip replacement at Jersey City Medical Center is $21,284. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,339. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 1.62x the Medicare baseline. Located in 355 Grand Street, Jersey City, NJ.

Cash / Self-Pay

$5,339

Average discount available for prompt cash payment at this facility.

Insurance Median

$21,284

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: $5,339 (41%)

Insurance Median: $21,284 (162%)

Cash: $5,339 (41% of Medicare)

Ins. Median: $21,284 (162% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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	$848 - $15,153	6%
Qualcare Inc	$2,700	21%
Blue Cross Blue Shield	$7,813 - $15,153	60%
Aetna	$15,153 - $26,240	116%
Clover Health	$15,153	116%
Fidelis Care	$15,153	116%
Humana	$15,153	116%
UnitedHealthcare	$15,456 - $26,500	118%
Cigna	$19,448 - $26,028	148%
Amerihealth	$21,284 - $23,943	162%
Emblem Health	$28,790	219%
Wellcare	$30,154	230%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $5,339.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 27130.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Jersey City Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 27130.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.