CMS Price Transparency Data

Total hip replacement

Facility: Mercy Medical Center

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27130
  • Insurance Median: $3,126
  • Cash Discount Price: $5,479
  • vs. Medicare Baseline: 0.24x Medicare
The contracted insurance negotiated median rate for a Total hip replacement at Mercy Medical Center is $3,126. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,479. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.24x the Medicare baseline. Located in 1320 Mercy Drive Nw, Canton, OH.
Cash / Self-Pay
$5,479

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,126

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: $5,479 (42%)
Insurance Median: $3,126 (24%)
Cash: $5,479 (42% of Medicare)
Ins. Median: $3,126 (24% 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
Summacare $793 - $11,889 6%
United $1,154 - $11,889 9%
Caresource $1,189 - $6,565 9%
Buckeye $1,212 - $6,565 9%
Aetna $1,219 - $11,889 9%
Blue Cross Blue Shield $1,219 - $11,889 9%
Cigna $1,219 - $12,245 9%
Humana $1,219 - $11,889 9%
The Health Plan $1,219 - $10,700 9%
Mmo $1,256 - $19,917 10%
Amerihealth $1,270 - $7,012 10%
Molina $1,270 - $6,693 10%
Communicare $1,280 - $12,483 10%
Perennial Health $1,317 - $12,840 10%
Zing Health $1,341 - $13,078 10%
Aultcare $1,402 11%
Oscar $2,250 17%
Ohcp $3,279 25%
Omas $4,214 32%
Phphi $5,057 39%
Gms $5,900 45%
Immergrun $6,322 48%
Multiplan $7,586 58%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1320 Mercy Drive Nw, Canton, OH 44708
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals