CMS Price Transparency Data

Total hip replacement

Facility: Cincinnati Children's Hospital Medical Center

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27130
  • Insurance Median: $6,266
  • Cash Discount Price: $5,215
  • vs. Medicare Baseline: 0.48x Medicare
The contracted insurance negotiated median rate for a Total hip replacement at Cincinnati Children's Hospital Medical Center is $6,266. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,215. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.48x the Medicare baseline. Located in 3333 Burnet Avenue, Cincinnati, OH.
Cash / Self-Pay
$5,215

Average discount available for prompt cash payment at this facility.

Insurance Median
$6,266

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: $5,215 (40%)
Insurance Median: $6,266 (48%)
Cash: $5,215 (40% of Medicare)
Ins. Median: $6,266 (48% 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
Blue Cross Blue Shield $866 - $8,645 7%
Caresource_In $909 - $1,212 7%
Aetna $976 - $10,225 7%
Humana $1,024 - $1,366 8%
Wellcare_Ky $1,024 - $1,366 8%
United_Health_Care_Ky $1,029 - $1,372 8%
Caresource_Oh $1,030 - $1,212 8%
Amerihealth_Caritas_Oh $1,060 - $1,247 8%
Molina_Oh $1,079 - $1,270 8%
Buckeye_Oh $1,128 - $1,327 9%
United_Health_Care_Oh $1,226 - $1,443 9%
Passport_Ky $1,353 10%
United_Health_Care_Insurance $3,898 - $8,186 30%
Caresource_Oh_Insurance $5,112 39%
Medical_Mutual_Of_Ohio_Insurance $5,475 - $9,305 42%
Parkview_Signature_Care_Insurance $6,266 - $7,372 48%
Point_Comfort_Insurance $6,646 51%
Margaret_Mary_Health_Insurance $6,779 - $7,976 52%
Cigna $6,953 - $8,180 53%
Health_Ohio_Network_Insurance $8,180 - $9,714 62%
Beechstreet_Insurance $8,257 - $9,714 63%
Private_Health_Care_Systems_Insurance $9,112 69%
Evolutions_Health_Care_Systems $9,202 70%
Galaxy_Health_Insurance $9,202 70%
Custom_Design_Benefits_Insurance $9,714 74%
First_Health_Group_Insurance $9,714 74%
Health_Link_Insurance $9,714 74%
Health_Smart_Preferred_Insurance $9,714 74%
Medical_Benefit_Administrators_Insurance $9,714 74%
Ohio_Health_Choice_Insurance $9,714 74%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3333 Burnet Avenue, Cincinnati, OH 45229
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens