CMS Price Transparency Data

Total hip replacement

Facility: St Mary Medical Center

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27130
  • Insurance Median: $500
  • Cash Discount Price: $2,825
  • vs. Medicare Baseline: 0.04x Medicare
The contracted insurance negotiated median rate for a Total hip replacement at St Mary Medical Center is $500. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,825. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.04x the Medicare baseline. Located in Langhorne-Newtown Rd, Langhorne, PA.
Cash / Self-Pay
$2,825

Average discount available for prompt cash payment at this facility.

Insurance Median
$500

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: $2,825 (22%)
Insurance Median: $500 (4%)
Cash: $2,825 (22% of Medicare)
Ins. Median: $500 (4% 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
Health America Advantra $117 - $16,609 1%
Medicare (plans) $117 - $24,913 1%
Amerihealth $120 - $4,829 1%
Bcn Domestic $120 - $1,129 1%
Blue Benefit Administrators Of Massachusetts $120 - $1,129 1%
Blue Care Network $120 - $1,129 1%
Blue Cross Blue Shield $120 - $13,841 1%
Blue Distinction Transplant $120 - $1,129 1%
Blue Shield - Ca $120 - $4,829 1%
Blue Shield - Id (Regence) $120 - $4,829 1%
Blue Shield - Ny Highmark Northeastern $120 - $1,129 1%
Blue Shield - Ny Highmark Western $120 - $4,829 1%
Blue Shield - Pa (Highmark) $120 - $37,426 1%
Blue Shield - Wa (Regence) $120 - $4,829 1%
Health Choices $120 - $1,129 1%
Kaiser Domestic $120 - $1,129 1%
Pre-Employment $120 - $1,129 1%
Wc Domestic $120 - $1,129 1%
Prime Healthcare $126 - $24,913 1%
Health Partners $129 - $1,212 1%
Jefferson Health Plan Commercial $129 - $25,190 1%
Ambetter / Centene $139 - $24,706 1%
Aetna $143 - $14,649 1%
Align Senior Care $143 - $14,118 1%
Ally Align Care Adv $143 - $893 1%
American Health Advantage Of Idaho $143 - $893 1%
American Health Plan $143 - $893 1%
Aurora Special Needs $143 - $893 1%
Blue Care Network Advantage $143 - $893 1%
Blue Shield - De (Highmark) Medciare Advantage $143 - $893 1%
Care Dimensions $143 - $893 1%
Care Improvement Plus $143 - $893 1%
Care Resources Pace $143 - $893 1%
Careplus Health Plans $143 - $893 1%
Cca - Zing Health $143 - $893 1%
Cca Senior Care Options $143 - $893 1%
Central Valley Medical Services Corp Pace $143 - $893 1%
Champion Health Plan Mcr Advantage $143 - $893 1%
Cigna $143 - $13,971 1%
Clear Spring Health $143 - $893 1%
Clover Health $143 - $893 1%
Commonwealth Care Alliance $143 - $893 1%
Community Pace At Home $143 - $893 1%
Eddy Senior Care-Pace $143 - $893 1%
Eddy Seniorcare Pace $143 - $893 1%
Elementcare $143 - $893 1%
Everence $143 - $893 1%
Gateway Health Plan $143 - $893 1%
Genesys Pace Of Genesee County $143 - $893 1%
Georgia Health Advantage $143 - $893 1%
Gold Advantage $143 - $893 1%
Gpa Croell Redi Mix $143 - $893 1%
Highmark Health Options Dual Plan $143 - $893 1%
Hope Select Pace $143 - $893 1%
Horizon Nj Total Care $143 - $893 1%
Hudson Headwaters Pace $143 - $893 1%
Humana $143 - $5,085 1%
Huron Valley Pace $143 - $893 1%
Innovative Integrated Health Community Plans $143 - $893 1%
Iowa Health Advantage $143 - $893 1%
Johns Hopkins Advantage Md $143 - $893 1%
Lasso Healthcare Msa $143 - $893 1%
Life St Marys Pace $143 - $893 1%
Lifecircles Pace $143 - $893 1%
Longevity Health Plan $143 - $893 1%
Longevity Ipa Of Michigan Llc Health Plan Isnp $143 - $893 1%
Martins Point Generations Advantage $143 - $893 1%
Mass General Brigham Mcr Adv $143 - $893 1%
Medipak Advantage $143 - $893 1%
Mercy Life $143 - $893 1%
Mercyone Cedar Valley $143 - $893 1%
Meridian Complete $143 - $893 1%
Michigan Complete Health $143 - $893 1%
Nascentia Health Plus $143 - $893 1%
New Centry Health Careplus $143 - $893 1%
Osu Prime Care Advantage $143 - $893 1%
Pace Cny $143 - $893 1%
Pace Iowa Immanuel Pathways $143 - $893 1%
Pace Of Southwest Michigan $143 - $893 1%
Pace Southeast $143 - $893 1%
Pace-Trinity Health $143 - $893 1%
Peak Pace Solutions $143 - $893 1%
Perennial Advantage $143 - $893 1%
Preferred Care Partners $143 - $893 1%
Presbyterian Senior Plan $143 - $893 1%
Provider Partners Health Plan Of Illinois $143 - $893 1%
Provider Partners Health Plan Of Indiana $143 - $893 1%
Pruitthealth Premier $143 - $893 1%
Reliance Community Care Partners Care Resources Pace $143 - $893 1%
Rx Allwin $143 - $893 1%
Rx Grane Grnmedd $143 - $893 1%
Rx Retiree Rx Care $143 - $893 1%
Scan Health Plan Mcr Ipa Meritage Oon $143 - $893 1%
Secure Horizons Ma Pffs $143 - $893 1%
Serenity Pace $143 - $893 1%
Siouxland Pace $143 - $893 1%
Solis Health Plans $143 - $893 1%
Sunnyview-Pace Finance Dept $143 - $893 1%
Texan Plus $143 - $893 1%
The Health Plan $143 - $893 1%
Thome Pace $143 - $893 1%
Todays Options $143 - $893 1%
Tribute Health Plans $143 - $893 1%
Um Health Advantage $143 - $893 1%
Union Health Service $143 - $893 1%
UnitedHealthcare $143 - $3,742 1%
Welbe Health $143 - $893 1%
Wellmed $143 - $893 1%
Oscar $144 - $24,913 1%
Evercare $146 - $911 1%
Veterans Administration $146 - $911 1%
Medicaid / KanCare $148 - $18,340 1%
Geha $149 - $3,742 1%
Champva $152 - $953 1%
Tricare $152 - $953 1%
Triwest Health Alliance $152 - $953 1%
Us Family Health Plan $152 - $953 1%
Veterans Eval Services $152 - $953 1%
Andrie Inc $165 - $1,030 1%
East Greenbush Central School District $165 - $1,030 1%
Genex Wc $165 - $1,030 1%
Healthsmart Workers Comp $165 - $1,030 1%
Jag Source $165 - $1,030 1%
New York State Insurance Fund $165 - $1,030 1%
Njm Insurance Group $165 - $1,030 1%
Rx Heatlhcomp $165 - $1,030 1%
Rx Restat $165 - $1,030 1%
Rx Saif Opdp Wc $165 - $1,030 1%
Rx Worker'S Comp $165 - $1,030 1%
Wc Accident Fund $165 - $1,030 1%
Wc Ace $165 - $1,030 1%
Wc Acs Federal Employees $165 - $1,030 1%
Wc Acuity $165 - $1,030 1%
Wc Advantage $165 - $1,030 1%
Wc Aegis $165 - $1,030 1%
Wc Aig $165 - $1,030 1%
Wc Aims $165 - $1,030 1%
Wc Alaska National Ins $165 - $1,030 1%
Wc Align Network $165 - $1,030 1%
Wc Allied $165 - $1,030 1%
Wc Am Trust N America $165 - $1,030 1%
Wc American Claims Mgmt $165 - $1,030 1%
Wc Amerisure $165 - $1,030 1%
Wc Amtrust $165 - $1,030 1%
Wc Asu Risk Mgt $165 - $1,030 1%
Wc Benetech $165 - $1,030 1%
Wc Berkley Admin $165 - $1,030 1%
Wc Broadspire $165 - $1,030 1%
Wc Broward County $165 - $1,030 1%
Wc Bunch & Associates $165 - $1,030 1%
Wc California State Comp Ins $165 - $1,030 1%
Wc California State Ins Fund $165 - $1,030 1%
Wc Capitol Area Health Consortium $165 - $1,030 1%
Wc Ccmsi $165 - $1,030 1%
Wc Chartis $165 - $1,030 1%
Wc Chubb $165 - $1,030 1%
Wc Cirma $165 - $1,030 1%
Wc City Of Albany $165 - $1,030 1%
Wc City Of Sioux City $165 - $1,030 1%
Wc Claims Mgmt Inc $165 - $1,030 1%
Wc Cna $165 - $1,030 1%
Wc Comp One Admin C/O Manageability $165 - $1,030 1%
Wc Compone Admin $165 - $1,030 1%
Wc Corvel $165 - $1,030 1%
Wc Ct Healthcare Trust $165 - $1,030 1%
Wc Donegal Insurance Group $165 - $1,030 1%
Wc Emc Insurance Company $165 - $1,030 1%
Wc Employee Mutual $165 - $1,030 1%
Wc Enablecomp $165 - $1,030 1%
Wc Encore Health Network $165 - $1,030 1%
Wc Erie $165 - $1,030 1%
Wc Esis $165 - $1,030 1%
Wc Evolutions $165 - $1,030 1%
Wc Fcci $165 - $1,030 1%
Wc Fed Ex $165 - $1,030 1%
Wc Federal Black Lung $165 - $1,030 1%
Wc Federated $165 - $1,030 1%
Wc Finley Occupational Health $165 - $1,030 1%
Wc First Agency/Occunet $165 - $1,030 1%
Wc Ford Motor $165 - $1,030 1%
Wc Fresno Unified Emp $165 - $1,030 1%
Wc Gallagher Bassett $165 - $1,030 1%
Wc General Motors $165 - $1,030 1%
Wc Generic $165 - $1,030 1%
Wc Genex Care For Ohio $165 - $1,030 1%
Wc Great West Casualty $165 - $1,030 1%
Wc Guarantee Insurance $165 - $1,030 1%
Wc Guard Insurance Company $165 - $1,030 1%
Wc Hab $165 - $1,030 1%
Wc Hartford $165 - $1,030 1%
Wc Hastings $165 - $1,030 1%
Wc Health Management $165 - $1,030 1%
Wc Heritage Summit $165 - $1,030 1%
Wc Hireright $165 - $1,030 1%
Wc Horizon $165 - $1,030 1%
Wc Icw Group $165 - $1,030 1%
Wc Idaho State Ins Fund $165 - $1,030 1%
Wc Intercare Insurance $165 - $1,030 1%
Wc Intermountain $165 - $1,030 1%
Wc Johns Eastern $165 - $1,030 1%
Wc Kemberton $165 - $1,030 1%
Wc Key Ins & Benefit Solutions $165 - $1,030 1%
Wc Liberty Mutual $165 - $1,030 1%
Wc Mac Risk Management $165 - $1,030 1%
Wc Massachusetts $165 - $1,030 1%
Wc Mdia $165 - $1,030 1%
Wc Meadowbrook Claim $165 - $1,030 1%
Wc Medical Administrators $165 - $1,030 1%
Wc Meijers $165 - $1,030 1%
Wc Memic $165 - $1,030 1%
Wc Mercy Workcare $165 - $1,030 1%
Wc Michigan $165 - $1,030 1%
Wc Michigan Millers Mutual $165 - $1,030 1%
Wc Mitchell Frankenmuth $165 - $1,030 1%
Wc Mra $165 - $1,030 1%
Wc Nationwide $165 - $1,030 1%
Wc Nca Comp $165 - $1,030 1%
Wc New York $165 - $1,030 1%
Wc New York Special Funds $165 - $1,030 1%
Wc North American Rishces $165 - $1,030 1%
Wc Northeast Health $165 - $1,030 1%
Wc Notre Dame $165 - $1,030 1%
Wc Novanet $165 - $1,030 1%
Wc O'Hara Corp $165 - $1,030 1%
Wc Occ Health Allen $165 - $1,030 1%
Wc Ohio Bureau $165 - $1,030 1%
Wc One Call Medical $165 - $1,030 1%
Wc Paradigm $165 - $1,030 1%
Wc Peerless $165 - $1,030 1%
Wc Pma $165 - $1,030 1%
Wc Praxis Health Network $165 - $1,030 1%
Wc Price Chopper $165 - $1,030 1%
Wc Procura Management $165 - $1,030 1%
Wc Qualcare $165 - $1,030 1%
Wc Quiktrip $165 - $1,030 1%
Wc Reny Company $165 - $1,030 1%
Wc Rev Claims $165 - $1,030 1%
Wc Risico $165 - $1,030 1%
Wc Rural Mutual $165 - $1,030 1%
Wc Saif Oregon $165 - $1,030 1%
Wc Secura $165 - $1,030 1%
Wc Sedgwick $165 - $1,030 1%
Wc Sentry $165 - $1,030 1%
Wc Sheakley Unicomp $165 - $1,030 1%
Wc Smile Lodge $165 - $1,030 1%
Wc Society $165 - $1,030 1%
Wc Srs $165 - $1,030 1%
Wc Taconic (Mro) $165 - $1,030 1%
Wc Taconic Farms $165 - $1,030 1%
Wc Travelers $165 - $1,030 1%
Wc Triad Group $165 - $1,030 1%
Wc Tristar $165 - $1,030 1%
Wc Troy Ny $165 - $1,030 1%
Wc Tyson $165 - $1,030 1%
Wc Unified Health Services $165 - $1,030 1%
Wc United Heartland $165 - $1,030 1%
Wc Us Dept Of Labor $165 - $1,030 1%
Wc Velocity $165 - $1,030 1%
Wc Walmart $165 - $1,030 1%
Wc West Bend $165 - $1,030 1%
Wc West Bend Mutual/Argent $165 - $1,030 1%
Wc Winnebago Industries $165 - $1,030 1%
Wc Yankee Trails $165 - $1,030 1%
Wc York Risk $165 - $1,030 1%
Wc Zenith $165 - $1,030 1%
Wc Zurich $165 - $1,030 1%
Homestead Health Plans Woods Center $190 - $26,990 1%
Group Pension Administrators $219 - $31,142 2%
Reedman Toll $219 - $31,142 2%
Coventry $240 - $2,247 2%
Health America $240 - $2,247 2%
Meritain $240 - $2,247 2%
Devon Health Services $407 - $5,085 3%
First Health $407 - $5,085 3%
Prime Health Services $429 - $5,368 3%
Three Rivers Provider Network $429 - $5,368 3%
Community Health Choice $486 - $500 4%
Albany County Correctional Facility $500 4%
Amish Mennonite $500 4%
Ascension St. Vincent Public Safety Medical $500 4%
Bcccp-Michigan $500 4%
Bccp $500 4%
Bmc Healthnet $500 4%
Breast Grant-Connecticut $500 4%
Broward County Dept Of Health $500 4%
California Health And Wellness $500 4%
Cardinal Innovations Lme $500 4%
Care Connections Of Northern Iowa $500 4%
Care Oregon Ohp $500 4%
Cencal Health Plan $500 4%
Cenpatico $500 4%
Chhuny $500 4%
Childrens Comm Health Plan $500 4%
Childrens Medical Services Title 19 $500 4%
City Of Philadelphia $500 4%
Cmh Allegan County $500 4%
Cmh Ausable Valley $500 4%
Cmh Barry County $500 4%
Cmh Bay-Arenac County $500 4%
Cmh Berrien County $500 4%
Cmh Cass County $500 4%
Cmh Central Mi County $500 4%
Cmh Clinton-Eaton-Ingham County $500 4%
Cmh Detroit Wayne Integrated Health Network $500 4%
Cmh Genesee County $500 4%
Cmh Ionia County $500 4%
Cmh Jackson County/Lifeways $500 4%
Cmh Kalamazoo $500 4%
Cmh Kent County $500 4%
Cmh Lenawee County $500 4%
Cmh Livingston County $500 4%
Cmh Macomb $500 4%
Cmh Misc $500 4%
Cmh Monroe County $500 4%
Cmh Montcalm County $500 4%
Cmh Muskegon County $500 4%
Cmh Newaygo County $500 4%
Cmh North Country $500 4%
Cmh Northern Lakes County $500 4%
Cmh Oakland County $500 4%
Cmh Ottawa County $500 4%
Cmh Van Buren County $500 4%
Cmh Washtenaw County $500 4%
Cmh Wayne County/Carelink $500 4%
Cmh Wayne Cty/Com Liv Svcs $500 4%
Cmh West Mi County $500 4%
Community Benefit Health $500 4%
Community Care Behavorial Health $500 4%
Community Care Partners $500 4%
Connections Csp $500 4%
County Coroner $500 4%
County Funding Generic $500 4%
Covid19 Hrsa Uninsured Testing And Treatment Fund $500 4%
Dean Wi Badgercare $500 4%
Delaware County Department Of Health $500 4%
Delaware First Health $500 4%
Delta Dental Nj $500 4%
Dph Tb Program $500 4%
Dscc $500 4%
Eastpointe Lme $500 4%
Family Health Network $500 4%
Freedom First Healthcare $500 4%
Fresno County Ccs $500 4%
Ghc Scw Wi Badgercare $500 4%
Harbor Health $500 4%
Health Safety Net $500 4%
Healthy Blue Ne $500 4%
Hennepin Health $500 4%
Id County Ada $500 4%
Id County Canyon $500 4%
Id County Cat Fund $500 4%
Id County Other $500 4%
Id County Payette $500 4%
Idaho Dept Health And Wellfare $500 4%
Idaho Womens Health Check $500 4%
Indiana Breast Cervical Cancer $500 4%
Inland Empire Health Plan $500 4%
Intercommunity Health Ohp $500 4%
Iowa Total Care $500 4%
Jai Medical System $500 4%
Kern Family Health Plan $500 4%
Keystone First $500 - $18,340 4%
Keystone First Chip $500 - $18,340 4%
La Care Health Plan $500 4%
Lakeland Care Inc $500 4%
Managed Health Services - Indiana $500 4%
Maryland Breast & Cervical Program $500 4%
Maryland Healthy Smiles - Scion Dental $500 4%
Maryland Physicians Care $500 4%
Massachusetts Behavioral Health Partnership $500 4%
Mdwise $500 4%
Medi-Cal $500 4%
Medi-Cal Healthnet $500 4%
Medstar Dc Healthy Family $500 4%
Medstar Md Health Choice $500 4%
Mo Home State Health Plan $500 4%
Molina Centennial Care $500 4%
Nascentia Health Options $500 4%
Nebraska Total Care $500 4%
New York Cancer Services Program $500 4%
Nextlevel Health $500 4%
Oregon Screenwise $500 4%
Paramount Advantage $500 4%
Parkland Community Health Plan $500 4%
Partners Behavioral Lme $500 4%
Peach State Healthplan $500 4%
Philadelphia County Funding $500 4%
Presbyterian Centennial Care $500 4%
Prestige Health Choice $500 4%
Priority Partners $500 4%
Robert F Sing Program $500 4%
Rx 340B Pass Along $500 4%
Rx Assistance/Rx Manufacturer Assistance 0 Copay $500 4%
Rx Medi-Cal $500 4%
Rx Meridian Rx $500 4%
Ryan White Florida Mssrp $500 4%
Sandhills Center Lme $500 4%
Screening For Life $500 4%
St Joseph County Hlth Dpt $500 4%
Stephenson Cty Health $500 4%
Sunshine State Health Plan $500 4%
Superior Health $500 4%
Tenncare $500 4%
Texas Children'S Health Plan $500 4%
Trillium Community Ohp $500 4%
Tufts Health Public Plans $500 4%
Vaya Health Lme $500 4%
Washtenaw Health Plan $500 4%
Wellsense Health Plan $500 4%
Wi Womens Wellness $500 4%
Multiplan $1,412 - $4,238 11%
Upmc Health Plan $7,033 54%
Webtpa $7,033 54%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Langhorne-Newtown Rd, Langhorne, PA 19047
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals