CMS Price Transparency Data

Total hip replacement

Facility: Geisinger Jersey Shore Hospital

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27130
Insurance Median: $6,450
Cash Discount Price: $7,940
vs. Medicare Baseline: 0.49x Medicare

The contracted insurance negotiated median rate for a Total hip replacement at Geisinger Jersey Shore Hospital is $6,450. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,940. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.49x the Medicare baseline. Located in 1020 Thompson Street, Jersey Shore, PA.

Cash / Self-Pay

$7,940

Average discount available for prompt cash payment at this facility.

Insurance Median

$6,450

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: $7,940 (61%)

Insurance Median: $6,450 (49%)

Cash: $7,940 (61% of Medicare)

Ins. Median: $6,450 (49% 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
Medicaid / KanCare	$1,000	8%
Amerihealth	$1,100	8%
Geisinger Family Plan	$1,100	8%
Upmc For You	$1,175	9%
Health Partners	$1,200	9%
Upmc Chip	$1,250	10%
Blue Cross Blue Shield	$1,646 - $9,116	13%
Geisinger Health Plan	$2,049 - $7,544	16%
UnitedHealthcare	$4,549 - $6,823	35%
Cigna	$4,918 - $7,377	37%
Christian Healthcare Ministries	$5,122 - $7,684	39%
Advantra	$5,147	39%
Aetna	$5,147 - $11,757	39%
American Progressive	$5,147	39%
Medicare (plans)	$5,147	39%
Humana	$5,198	40%
Medical Development International	$7,172 - $10,758	55%
Integrated Health Plan	$7,684 - $11,526	59%
Prime Health Services	$7,684 - $11,526	59%
Multiplan	$8,196 - $12,294	62%
Ambetter / Centene	$12,352	94%
Prison Health Services	$15,286	117%

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 $7,940.
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 Geisinger Jersey Shore Hospital 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.