CMS Price Transparency Data

Total hip replacement

Facility: Nationwide Children's Hospital

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27130
  • Insurance Median: $4,847
  • Cash Discount Price: $5,817
  • vs. Medicare Baseline: 0.37x Medicare
The contracted insurance negotiated median rate for a Total hip replacement at Nationwide Children's Hospital is $4,847. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,817. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.37x the Medicare baseline. Located in 700 Children's Drive, Columbus, OH.
Cash / Self-Pay
$5,817

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,847

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: $5,817 (44%)
Insurance Median: $4,847 (37%)
Cash: $5,817 (44% of Medicare)
Ins. Median: $4,847 (37% 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
Tricare $1,158 - $12,223 9%
Caresource $1,694 - $19,675 13%
Humana $2,906 - $12,108 22%
Ohio Ppo Connect $3,658 28%
Osu $3,658 28%
UnitedHealthcare $3,664 - $12,108 28%
Blue Cross Blue Shield $3,889 - $12,108 30%
Aetna $4,028 - $4,847 31%
Mmo $4,653 35%
Cigna $4,847 37%
Front Path Health Coalition $4,847 37%
Ohc $4,847 37%
Ohg $4,847 37%
The Health Plan $4,847 37%
Amerihealth $12,108 92%
Bchp $12,108 92%
Molina $12,108 92%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 700 Children's Drive, Columbus, OH 43205
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens