CMS Price Transparency Data

Total hip replacement

Facility: Jamaica Hospital Medical Center

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27130
  • Insurance Median: $15,948
  • Cash Discount Price: $4,917
  • vs. Medicare Baseline: 1.22x Medicare
The contracted insurance negotiated median rate for a Total hip replacement at Jamaica Hospital Medical Center is $15,948. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,917. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 1.22x the Medicare baseline. Located in 89Th Avenue and Van Wyck Expressway, Jamaica, NY.
Cash / Self-Pay
$4,917

Average discount available for prompt cash payment at this facility.

Insurance Median
$15,948

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: $4,917 (37%)
Insurance Median: $15,948 (122%)
Cash: $4,917 (37% of Medicare)
Ins. Median: $15,948 (122% 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
Hotel Trades Council $1,912 15%
Create Health Plan $3,399 26%
Aetna $3,797 - $15,948 29%
Oscar $4,018 31%
Empire Blue Priority $4,031 31%
UnitedHealthcare $4,215 - $15,948 32%
Cigna $4,250 32%
Magnacare $4,555 - $18,340 35%
Centivo $4,679 36%
Empire $4,742 - $15,948 36%
Hip $5,159 - $15,948 39%
Metroplus $13,000 - $17,000 99%
Healthfirst $13,556 103%
Fidelis $15,150 - $15,948 116%
Beacon Health Strategies $15,948 122%
Centerlight Healthcare $15,948 122%
Ghi $15,948 122%
Elderplan $16,267 124%
Vns $16,267 124%
Wellcare Of Ny $16,586 126%
Villagecaremax $16,745 128%
Humana $16,905 129%
Senior Whole Health $16,905 129%
1999 National Benefit Fund $17,237 131%
Hamaspik Choice $18,340 140%
Centers Plan For Healthy Living $19,935 152%
Emblemhealth $26,314 201%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 89Th Avenue and Van Wyck Expressway, Jamaica, NY 11418
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals