CMS Price Transparency Data

Total hip replacement

Facility: Milton S Hershey Medical Center

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27130
Insurance Median: $15,054
Cash Discount Price: $27,708
vs. Medicare Baseline: 1.15x Medicare

The contracted insurance negotiated median rate for a Total hip replacement at Milton S Hershey Medical Center is $15,054. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $27,708. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 1.15x the Medicare baseline. Located in 500 University Drive, Hershey, PA.

Cash / Self-Pay

$27,708

Average discount available for prompt cash payment at this facility.

Insurance Median

$15,054

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: $27,708 (211%)

Insurance Median: $15,054 (115%)

Cash: $27,708 (211% of Medicare)

Ins. Median: $15,054 (115% 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
[Amerihealth Caritas]	$11,574 - $13,617	88%
[Highmark Wholecare]	$11,574 - $13,617	88%
[Geisinger]	$12,255 - $62,324	93%
[Health Partners Plans]	$12,663 - $13,889	97%
[Pa Health & Wellness]	$12,731 - $14,025	97%
[Highmark]	$13,480 - $73,226	103%
Aetna	$13,753 - $56,645	105%
Humana	$13,753	105%
[Healthspring]	$13,753	105%
UnitedHealthcare	$13,889 - $60,300	106%
[Upmc]	$13,889 - $61,789	106%
[Cbc]	$15,054 - $55,391	115%
[Point Comfort Underwriters]	$17,021	130%
[Highmark Aca]	$51,258	391%
Cigna	$53,467	408%
[Highmark Choice Blue]	$58,580	447%
[Preferred Healthcare Systems]	$62,726	478%
[First Health]	$66,907	510%
[Multiplan]	$66,907	510%

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 $27,708.
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 Milton S Hershey 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.