CMS Price Transparency Data

Total hip replacement

Facility: Albany Medical Center Hospital

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27130
  • Insurance Median: $1,442
  • Cash Discount Price: $2,219
  • vs. Medicare Baseline: 0.11x Medicare
The contracted insurance negotiated median rate for a Total hip replacement at Albany Medical Center Hospital is $1,442. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,219. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.11x the Medicare baseline. Located in 43 New Scotland Avenue, Mail Code 34, Albany, NY.
Cash / Self-Pay
$2,219

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,442

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: $2,219 (17%)
Insurance Median: $1,442 (11%)
Cash: $2,219 (17% of Medicare)
Ins. Median: $1,442 (11% 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
Magnacare $238 2%
Medicaid / KanCare $697 - $1,181 5%
Cdphp $816 - $20,423 6%
Medicare (plans) $900 - $1,376 7%
Fidelis $944 - $26,037 7%
Blue Cross Blue Shield $989 - $15,226 8%
Tricare $1,019 - $1,199 8%
Hamaspik $1,121 - $20,707 9%
Blue Shield Highmark $1,142 - $2,697 9%
UnitedHealthcare $1,199 - $2,982 9%
Mvp $1,207 - $14,465 9%
Aetna $1,247 - $15,987 10%
Nascentia $1,319 10%
Emblem Health Ghi $1,331 - $2,603 10%
Cigna $1,885 - $2,281 14%
Nys Department Of Corrections $2,941 22%
Blue Shield $3,272 - $4,404 25%
Mvp Essential Plan $8,924 68%
Empire Plan Nyship $10,729 82%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 43 New Scotland Avenue, Mail Code 34, Albany, NY 12208
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals