CMS Price Transparency Data

Total hip replacement

Facility: Bertrand Chaffee Hospital

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27130
Insurance Median: $1,729
Cash Discount Price: $1,731
vs. Medicare Baseline: 0.13x Medicare

The contracted insurance negotiated median rate for a Total hip replacement at Bertrand Chaffee Hospital is $1,729. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,731. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.13x the Medicare baseline. Located in 224 East Main Street, Springville, NY.

Cash / Self-Pay

$1,731

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,729

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: $1,731 (13%)

Insurance Median: $1,729 (13%)

Cash: $1,731 (13% of Medicare)

Ins. Median: $1,729 (13% 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
Univera Healthcare	$243	2%
Univera Senior Choice	$243 - $1,456	2%
Medicare (plans)	$1,199 - $1,204	9%
Tricare	$1,199 - $1,204	9%
Advantra-Mcr Advantage	$1,204	9%
Aetna	$1,204 - $2,185	9%
Centers Plan Hlty Living	$1,204	9%
Champva	$1,204	9%
Cigna	$1,204 - $2,185	9%
Ctrs Plan For Hlthy Livng	$1,204	9%
Geisinger Health Plan	$1,204	9%
Humana	$1,204	9%
Iha Encompass 65	$1,204	9%
Lifetime Benefits	$1,204	9%
Mutual Of Omaha	$1,204	9%
Optimum Healthcare - Mcr	$1,204	9%
Todays Option - Amer Prog	$1,204	9%
United Hc Mcr Solutions	$1,204	9%
UnitedHealthcare	$1,204	9%
Wellcare	$1,204	9%
Private Pay	$1,605 - $1,857	12%
Blue Cross Blue Shield	$1,729 - $4,160	13%
American Progressive Ins.	$1,888 - $2,185	14%
Commercial / Misc	$1,888 - $2,185	14%
Global Excel Mgt	$1,888 - $2,185	14%
Guardian Life Ins. Co.	$1,888 - $2,185	14%
Mvp Commercial	$1,888 - $2,185	14%
No Amer Meritian Health	$1,888 - $2,185	14%
No-Fault	$1,888 - $2,185	14%
Nova Healthcare	$2,185	17%
Senior Blue - Bc	$3,140	24%

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 $1,731.
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 Bertrand Chaffee Hospital 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.