CMS Price Transparency Data

Total hip replacement

Facility: Coshocton Regional Medical Center

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27130
Insurance Median: $11,888
Cash Discount Price: $12,086
vs. Medicare Baseline: 0.91x Medicare

The contracted insurance negotiated median rate for a Total hip replacement at Coshocton Regional Medical Center is $11,888. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $12,086. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.91x the Medicare baseline. Located in 1460 Orange Street, Coshocton, OH.

Cash / Self-Pay

$12,086

Average discount available for prompt cash payment at this facility.

Insurance Median

$11,888

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: $12,086 (92%)

Insurance Median: $11,888 (91%)

Cash: $12,086 (92% of Medicare)

Ins. Median: $11,888 (91% 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
Buckeye Community Health Plan	$4,007 - $11,888	31%
Care Source	$4,007 - $11,888	31%
Medicaid / KanCare	$4,007	31%
Molina	$4,088 - $11,888	31%
Blue Cross Blue Shield	$4,128 - $11,888	31%
Amerihealth Caritas	$4,208	32%
Paramount	$4,208	32%
Quality Care Partner	$4,208	32%
UnitedHealthcare	$4,208 - $11,888	32%
Standard Eapg Logic	$10,373	79%
Americas Choice Provider Network	$11,888	91%
Corvel	$11,888	91%
Devoted Health	$11,888	91%
Employer Direct Healthcare	$11,888	91%
Healthsmart	$11,888	91%
Med Mutual Of Oh	$11,888	91%
Medicare (plans)	$11,888	91%
Multiplan	$11,888	91%
Perennial Advantage	$11,888	91%
Provider Network Of America	$11,888	91%
Provider Select	$11,888	91%
The Health Plan	$11,888	91%
Three Rivers	$11,888	91%
Tricare	$11,888	91%
Valor Health Plan	$11,888	91%
Workers Compensation	$11,888	91%

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 $12,086.
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 Coshocton Regional 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.