CMS Price Transparency Data

Total hip replacement

Facility: Ohio Valley Surgical Hospital

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27130
  • Insurance Median: $12,263
  • Cash Discount Price: $31,423
  • vs. Medicare Baseline: 0.93x Medicare
The contracted insurance negotiated median rate for a Total hip replacement at Ohio Valley Surgical Hospital is $12,263. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $31,423. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.93x the Medicare baseline. Located in 100 West Main Street, Springfield, OH.
Cash / Self-Pay
$31,423

Average discount available for prompt cash payment at this facility.

Insurance Median
$12,263

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: $31,423 (240%)
Insurance Median: $12,263 (93%)
Cash: $31,423 (240% of Medicare)
Ins. Median: $12,263 (93% 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
Aetna $1,508 - $12,263 11%
Geha $1,508 11%
Genworth $1,508 11%
Mail Handlers $1,508 11%
Meritain $1,508 11%
Meritain Heatlh $1,508 11%
Mhbp $1,508 11%
Ngs Coresource $1,508 11%
Nippon Life $1,508 11%
Pacific Source $1,508 11%
Personify Health $1,508 11%
UnitedHealthcare $6,136 - $12,263 47%
Aarp $12,263 93%
Aarp Supplemental $12,263 93%
American Continental Insurance $12,263 93%
American Continental Life $12,263 93%
American Republic $12,263 93%
American Retirement $12,263 93%
Aultcare Primetime Health Plan $12,263 93%
Bankers Fidelity $12,263 93%
Bankers Life And Casualty $12,263 93%
Blue Cross Blue Shield $12,263 - $51,586 93%
Central States $12,263 93%
Champus $12,263 93%
Cigna $12,263 - $19,665 93%
Communicare Advantage $12,263 93%
Everest $12,263 93%
Gateway Health Plan $12,263 93%
Medicare (plans) $12,263 - $31,423 93%
Medigold $12,263 93%
Mmoh $12,263 - $32,994 93%
Molina $12,263 93%
Molina Dual Mcr $12,263 93%
Molina Marketplace $12,263 93%
Molina Dual Mcr $12,263 93%
Molina Mcr $12,263 93%
Molina Mcr Mcd $12,263 93%
Molina Mcr+Mcd $12,263 93%
Patient No Pay $12,263 93%
Prosperity Supplement $12,263 93%
Self Pay Imaging $12,263 93%
Wellcare By Allwell $12,263 93%
Wraparound Pl Supp $12,263 93%
The Health Plan $12,876 98%
Humana $13,000 99%
Employer Direct $13,414 102%
Devoted Health $14,683 112%
Caresource $18,395 140%
Caresourse $18,395 140%
Medicaid / KanCare $18,395 140%
Healthgram $19,665 150%
Nalc $19,665 150%
Samba $19,665 150%
Sbma $19,665 150%
Unified Group $19,665 150%
Mmoh (Supermed) $24,353 186%
Mmo Cin. Hmo $32,994 252%
Luminare Health $47,135 359%
Medben $47,135 359%
Ohio Health $47,135 359%
Preferred Health $47,135 359%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 West Main Street, Springfield, OH 45502
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals