CMS Price Transparency Data

Total hip replacement

Facility: Wheeling Hospital, Inc

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27130
  • Insurance Median: $12,543
  • Cash Discount Price: $15,517
  • vs. Medicare Baseline: 0.96x Medicare
The contracted insurance negotiated median rate for a Total hip replacement at Wheeling Hospital, Inc is $12,543. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $15,517. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.96x the Medicare baseline. Located in 1 Medical Park, Wheeling, WV.
Cash / Self-Pay
$15,517

Average discount available for prompt cash payment at this facility.

Insurance Median
$12,543

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: $15,517 (118%)
Insurance Median: $12,543 (96%)
Cash: $15,517 (118% of Medicare)
Ins. Median: $12,543 (96% 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 Pennsylvania $776 6%
Pennsylvania Health & Wellness $776 6%
Highmark Health Options West Va $982 7%
Wellpoint West Virginia $982 7%
The Health Plan Wv $996 8%
Aetna $1,000 - $12,976 8%
Medicaid / KanCare $8,033 61%
Blue Cross Blue Shield $12,358 - $50,708 94%
Buckeye Commercial $12,358 94%
Medicare (plans) $12,358 - $13,099 94%
Humana $12,976 99%
Senior Life Pa - Ma $12,976 99%
UnitedHealthcare $13,470 103%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1 Medical Park, Wheeling, WV 26003
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals