CMS Price Transparency Data

Total hip replacement

Facility: Jfk University Medical Center

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27130
  • Insurance Median: $12,559
  • Cash Discount Price: $13,560
  • vs. Medicare Baseline: 0.96x Medicare
The contracted insurance negotiated median rate for a Total hip replacement at Jfk University Medical Center is $12,559. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $13,560. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.96x the Medicare baseline. Located in 65 James Street, Edison, NJ.
Cash / Self-Pay
$13,560

Average discount available for prompt cash payment at this facility.

Insurance Median
$12,559

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: $13,560 (103%)
Insurance Median: $12,559 (96%)
Cash: $13,560 (103% of Medicare)
Ins. Median: $12,559 (96% 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 $1,690 - $14,254 13%
Karna $2,746 21%
Aetna $2,888 - $14,254 22%
UnitedHealthcare $3,084 - $30,154 24%
Clover $3,229 25%
Seoul Medical Group $3,857 29%
Amerigroup $4,701 - $14,254 36%
Qualcare $9,170 - $9,342 70%
Brighton Health Plan $10,163 77%
Amerihealth $10,711 - $11,904 82%
Activecare First McO $12,559 96%
Intergroup $12,559 96%
Vaccn $12,867 - $14,254 98%
Wellcare $12,867 - $14,254 98%
Bergen Risk $13,456 103%
United Community/Americhoice $13,510 - $14,967 103%
Blue Cross Blue Shield $14,254 109%
Prime Health $14,353 109%
Multiplan - PHCS $15,250 116%
Cigna $15,754 120%
Oxford $24,137 184%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 65 James Street, Edison, NJ 08818
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals