CMS Price Transparency Data

Total hip replacement

Facility: Lehigh Valley Hospital

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27130
  • Insurance Median: $7,029
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.54x Medicare
The contracted insurance negotiated median rate for a Total hip replacement at Lehigh Valley Hospital is $7,029. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.54x the Medicare baseline. Located in 1200 South Cedar Crest Boulevard, Allentown, PA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$7,029

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%)
Insurance Median: $7,029 (54%)
Ins. Median: $7,029 (54% 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
Amerihealth Caritas $854 - $1,397 7%
UnitedHealthcare $954 - $45,598 7%
Geisinger $970 - $58,992 7%
Highmark Wholecare/Gateway $986 8%
Jefferson Health Partners $1,048 - $26,844 8%
Pa Health & Wellness $1,048 8%
Aetna $1,125 - $74,438 9%
Keystone First $1,125 9%
Upmc $1,277 - $65,365 10%
Amerihealth $1,576 - $13,825 12%
Blue Cross Blue Shield $1,576 - $31,343 12%
Ibc $1,576 - $13,422 12%
Highmark Blue Shield $1,608 - $43,393 12%
Cigna $1,623 - $13,825 12%
Devoted Health $1,671 - $14,227 13%
Humana $1,671 - $14,227 13%
Gateway $1,686 - $14,361 13%
Emblem $1,702 - $59,862 13%
Pa Health & Wellness (Allwell) $1,734 - $14,764 13%
Ambetter / Centene $4,780 - $40,709 36%
Valley Preferred $9,191 - $78,270 70%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1200 South Cedar Crest Boulevard, Allentown, PA 18103
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals