CMS Price Transparency Data

Total hip replacement

Facility: Metropolitan Hospital Center

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27130
  • Insurance Median: $4,237
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.32x Medicare
The contracted insurance negotiated median rate for a Total hip replacement at Metropolitan Hospital Center is $4,237. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.32x the Medicare baseline. Located in 1901 First Avenue, New York, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,237

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%)
Insurance Median: $4,237 (32%)
Ins. Median: $4,237 (32% 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
United $957 - $5,192 7%
Healthfirst $1,214 - $9,346 9%
Amidacare $1,517 12%
Emblem $1,517 - $22,839 12%
Wellcare $1,639 12%
Metroplus $1,871 - $4,154 14%
Fidelis $2,185 - $21,621 17%
Blue Cross Blue Shield $4,154 - $15,226 32%
Carelon $4,154 32%
Senior Whole Health $4,154 32%
United Behavioral Health $4,154 - $4,569 32%
Affinity $4,237 - $9,346 32%
Carelon (Amida Care) $4,237 32%
Vnsny $4,237 - $15,226 32%
Aetna $15,226 116%
Vaccn $15,226 116%
Centers Plan For Healthy Living $15,835 121%
Oscar $22,839 174%
Elderplan $30,452 232%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1901 First Avenue, New York, NY 10029
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals