CMS Price Transparency Data

Total hip replacement

Facility: Univ. of Vermont - Fletcher Allen Health Care

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27130
Insurance Median: $3,605
Cash Discount Price: $5,184
vs. Medicare Baseline: 0.27x Medicare

The contracted insurance negotiated median rate for a Total hip replacement at Univ. of Vermont - Fletcher Allen Health Care is $3,605. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,184. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.27x the Medicare baseline. Located in 111 Colchester Ave, Burlington, VT.

Cash / Self-Pay

$5,184

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,605

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: $5,184 (40%)

Insurance Median: $3,605 (27%)

Cash: $5,184 (40% of Medicare)

Ins. Median: $3,605 (27% 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
UnitedHealthcare	$840 - $12,967	6%
Mvp	$1,015 - $13,291	8%
Aetna	$1,194 - $12,967	9%
Capital District Physicians' Health Plan	$1,194 - $12,967	9%
Humana	$1,194 - $12,967	9%
Martins Point	$1,194 - $13,291	9%
St. Regis	$1,194 - $12,967	9%
Veterans Affairs Community Care Network	$1,194 - $12,967	9%
Blue Cross Blue Shield	$1,217 - $13,503	9%
Fidelis Care	$1,373 - $14,264	10%
Wellpath	$1,671 - $19,451	13%
Ebpa	$3,992	30%
Harvard Pilgrim	$4,147	32%
Magnacare	$4,147	32%
Coventry	$4,406	34%
Cigna	$4,540	35%
Nppn	$4,666	36%

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 $5,184.
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 Univ. of Vermont - Fletcher Allen Health Care 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.