CMS Price Transparency Data

Total hip replacement

Facility: Memorial Hospital for Cancer and Allied Diseases

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27130
Insurance Median: $5,885
Cash Discount Price: $7,511
vs. Medicare Baseline: 0.45x Medicare

The contracted insurance negotiated median rate for a Total hip replacement at Memorial Hospital for Cancer and Allied Diseases is $5,885. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,511. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.45x the Medicare baseline. Located in 1275 York Ave, New York, NY.

Cash / Self-Pay

$7,511

Average discount available for prompt cash payment at this facility.

Insurance Median

$5,885

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: $7,511 (57%)

Insurance Median: $5,885 (45%)

Cash: $7,511 (57% of Medicare)

Ins. Median: $5,885 (45% 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
Emblem	$697 - $6,266	5%
Aetna	$1,467 - $8,622	11%
Fidelis	$1,467	11%
Healthfirst	$1,467 - $4,256	11%
Metroplus	$1,467	11%
Magnacare	$1,492 - $10,360	11%
Urn	$1,616 - $10,101	12%
6 Degrees Health	$1,658 - $10,360	13%
Multiplan	$1,865 - $11,655	14%
Empire	$6,131 - $7,664	47%
Oxford	$7,184 - $8,537	55%
Cigna	$8,110	62%
UnitedHealthcare	$8,878	68%

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 $7,511.
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 Memorial Hospital for Cancer and Allied Diseases 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.