CMS Price Transparency Data

Total hip replacement

Facility: Garnet Health Medical Center

Billing Code: 27130 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$12,565

about 1.0× the $13,117 Medicare rate · typically $8,003–$21,647

modeled estimate · not a bill or quote

What this hospital charges insurers

$6,602

Below the fair price — a good deal

about $5,963 under the fair price · 0.5× Medicare

Medicare pays $13,117 Fair price $12,565 This hospital $6,602

How we calculate the fair BaseRate →

How this hospital compares to other NY hospitals

Highest price of the 9 NY hospitals we have prices for — worth calling around.

Cheapest $2,702 Priciest $6,602

Black dot = this hospital, among the 9 NY hospitals with a price for this procedure. Full list below.

A fair price for a Total hip replacement is about $12,565 (about 1.0× the $13,117 Medicare rate). Garnet Health Medical Center charges insurers about $6,602 — below the fair price — a good deal. Located in Middletown, NY.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$4,862	37%
Blue Cross Blue Shieldmajor	$9,924 - $10,355	76%
Aetnamajor	$4,319 - $16,026	33%
Cignamajor	$5,396	41%
CDPHP	$10,502	80%
Fidelis Care	$16,347	125%
Geisinger	$40,066	305%
MagnaCare	$3,669 - $5,870	28%
MVP Health Care	$6,496	50%
WellCare	$16,395	125%
+ 4 smaller / regional plans	$4,319 - $32,854

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price, before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 27130.

Insurance Before you use insurance

Call your insurance company to confirm Garnet Health Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 27130.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Garnet Health Medical Center

Compare: Total hip replacement at other NY hospitals

Niagara Falls Memorial Medical Center · Niagara Falls $2,702
Nassau University Medical Center · East Meadow $2,954
Brooks-Tlc Hospital System, Inc · Dunkirk $3,327
Arnot Ogden Medical Center · Elmira $3,804
Metropolitan Hospital Center · New York $4,237
Harlem Hospital Center · New York $4,254
Jacobi Medical Center · Bronx $4,265
South Brooklyn Health · Brooklyn $4,323

Insurance negotiated median for the same procedure, sorted lowest first.