CMS Price Transparency Data

Total hip replacement

Facility: Wyckoff Heights Medical Center

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27130
Insurance Median: $15,948
Cash Discount Price: $25,500
vs. Medicare Baseline: 1.22x Medicare

The contracted insurance negotiated median rate for a Total hip replacement at Wyckoff Heights Medical Center is $15,948. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $25,500. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 1.22x the Medicare baseline. Located in 374 Stockholm Street, Brooklyn, NY.

Cash / Self-Pay

$25,500

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: $25,500 (194%)

Insurance Median: $15,948 (122%)

Cash: $25,500 (194% 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.

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
UnitedHealthcare	$2,096 - $15,948	16%
Cigna	$2,105 - $3,389	16%
Aetna	$2,249 - $15,948	17%
Emblem Health	$3,380 - $18,340	26%
Oscar	$3,723	28%
Healthfirst	$13,237	101%
Metroplus	$15,629 - $17,543	119%
Affinity Health	$15,948	122%
Amerigroup	$15,948	122%
Blue Cross Blue Shield	$15,948	122%
Centers Plan For Health Living	$15,948	122%
Fidelis	$15,948	122%
Interga	$15,948	122%
Partners Health Plan	$16,267	124%
Wellcare	$16,315 - $17,862	124%
Senior Whole Health	$16,426	125%
Agewell	$16,745	128%
Alphacare	$16,745	128%
Amida Care	$16,745	128%
Elderplan	$16,745	128%
Hamaspik	$16,745	128%
Humana	$16,745	128%
Visiting Nurse Services	$16,745	128%

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 $25,500.
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 Wyckoff Heights Medical Center 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.