CMS Price Transparency Data

Total hip replacement

Facility: Kosciusko Community Hospital

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27130
  • Insurance Median: $2,153
  • Cash Discount Price: $788
  • vs. Medicare Baseline: 0.16x Medicare
The contracted insurance negotiated median rate for a Total hip replacement at Kosciusko Community Hospital is $2,153. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $788. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.16x the Medicare baseline. Located in 2101 E Dubois Dr, Warsaw, IN.
Cash / Self-Pay
$788

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,153

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: $788 (6%)
Insurance Median: $2,153 (16%)
Cash: $788 (6% of Medicare)
Ins. Median: $2,153 (16% 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
Amish Aid $284 - $29,465 2%
Self Pay $284 - $29,465 2%
Lutheran Preferred Network $428 - $112,247 3%
Physicians Health Plan $500 - $64,655 4%
Php Freedom Network $523 - $54,187 4%
UnitedHealthcare $528 - $73,803 4%
Encore $542 - $56,124 4%
Trma Inc $542 - $63,139 4%
Aetna $555 - $74,645 4%
Connecticut General Life Insurance Company $798 - $82,642 6%
Cigna $856 - $88,676 7%
First Health Network $1,016 - $105,232 8%
Prime Health Services $1,016 - $105,232 8%
One Call Care Diagnostics Wc $1,064 8%
Advantage Health $1,124 - $116,457 9%
Veterans Eval Services $1,154 9%
Private Healthcare Systems $1,164 - $120,666 9%
Sagamore $1,192 - $131,891 9%
Encore Health Network $1,259 - $130,488 10%
Blue Cross Blue Shield $14,292 - $55,822 109%
Humana $14,292 - $26,103 109%
Medicare (plans) $14,292 109%
Mhs $14,292 - $26,103 109%
Iu Health $14,548 111%
Node Non Par Hospice Agree $14,548 111%
Node Va $14,548 111%
Node Devoted Health Mcr Adv $14,577 111%
In Dept Of Correction $15,130 115%
Node Pphp Mcr Adv $15,275 116%
Us Department Of Labor $18,185 139%
Caresource $20,080 - $26,103 153%
Lutheran Advanced Network $21,822 166%
Lutheran Preferred $21,822 - $29,096 166%
Align In Work Comp $23,277 177%
One Call Work Comp $23,277 177%
Managed Health Services $26,103 199%
Medicaid / KanCare $26,103 199%
Encore Work Comp In $26,186 200%
Managed Health Services Exchange $29,096 222%
Workers Comp $29,096 222%
Encore Kba Epo $34,915 266%
Encore Kba Ppo $43,644 333%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2101 E Dubois Dr, Warsaw, IN 46580
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals