CMS Price Transparency Data

Total hip replacement

Facility: Jefferson Einstein Montgomery Hospital

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27130
  • Insurance Median: $13,376
  • Cash Discount Price: $15,086
  • vs. Medicare Baseline: 1.02x Medicare
The contracted insurance negotiated median rate for a Total hip replacement at Jefferson Einstein Montgomery Hospital is $13,376. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $15,086. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 1.02x the Medicare baseline. Located in 559 West Germantown Pike, East Norriton, PA.
Cash / Self-Pay
$15,086

Average discount available for prompt cash payment at this facility.

Insurance Median
$13,376

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: $15,086 (115%)
Insurance Median: $13,376 (102%)
Cash: $15,086 (115% of Medicare)
Ins. Median: $13,376 (102% 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
Geisinger $1,050 - $51,910 8%
Upmc $2,734 - $13,376 21%
Aetna $8,985 - $13,503 69%
Cigna $9,026 - $13,248 69%
United $10,855 - $12,993 83%
Humana $12,739 97%
Highmark $13,376 102%
Advantra $13,503 103%
Wellcare $14,013 107%
Ibc $17,834 - $18,193 136%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 559 West Germantown Pike, East Norriton, PA 19403
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals