CMS Price Transparency Data

Total hip replacement

Facility: Erlanger Medical Center

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27130
Insurance Median: $2,175
Cash Discount Price: $1,465
vs. Medicare Baseline: 0.17x Medicare

The contracted insurance negotiated median rate for a Total hip replacement at Erlanger Medical Center is $2,175. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,465. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.17x the Medicare baseline. Located in 975 E 3Rd St, Chattanooga, TN.

Cash / Self-Pay

$1,465

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,175

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: $1,465 (11%)

Insurance Median: $2,175 (17%)

Cash: $1,465 (11% of Medicare)

Ins. Median: $2,175 (17% 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
Humana	$1,097 - $11,803	8%
UnitedHealthcare	$1,148 - $12,393	9%
Cigna	$1,198 - $18,225	9%
Bluecare	$1,322 - $12,275	10%
Amerigroup	$1,327 - $3,667	10%
Caresource	$1,327 - $23,606	10%
Peach State Hlth Plan	$1,327	10%
Blue Cross Blue Shield	$1,391 - $11,803	11%
Alexian	$1,630 - $11,884	12%
Clover	$1,630 - $11,803	12%
Medicare (plans)	$1,630	12%
Upmc	$1,630 - $11,803	12%
Aetna	$1,638 - $12,157	12%
Pruitthealth Premier	$1,670	13%
American Health	$1,679 - $12,157	13%
Devoted Health	$1,696 - $12,275	13%
Nhc	$1,712 - $12,393	13%
Atrio Health	$1,793 - $12,983	14%
Simpra Advantage	$1,793	14%
Ambetter / Centene	$2,038 - $14,754	16%
Caresource Ga	$2,279 - $4,087	17%
Caresource Tn	$2,279 - $4,087	17%
Olympus	$2,446 - $2,772	19%
Alliant	$2,609	20%
Pnoa	$2,662 - $29,507	20%
Caresource Nc	$2,751 - $4,087	21%
Occunet	$2,853 - $11,213	22%
Point Comfort Underwriters	$2,863 - $2,935	22%
Wellpoint	$12,240	93%

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 $1,465.
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 Erlanger 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.