Total hip replacement
Facility: Susan B Allen Memorial Hospital
Billing Code: 27130 (CPT)
- CPT Billing Code: 27130
- Insurance Median: $554
- Cash Discount Price: $7,181
- vs. Medicare Baseline: 0.04x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
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 | $350 | 3% |
| Providrs Care | $757 | 6% |
Consumer Guidance & Cost Commentary
For a total hip replacement at Susan B Allen Memorial Hospital in El Dorado, KS, the facility's cash median price is $7,181.00, which is lower than the gross charge of $11,048.00. While the hospital's negotiated rates for UnitedHealthcare and Providrs Care are set at $350 and $757 respectively, these amounts are significantly lower than the Medicare benchmark of $13,116.76. Patients with high-deductible plans may find paying the cash price of $7,181.00 more cost-effective than relying on insurance, as the negotiated rates often include administrative overhead that inflates the baseline price by 20% to 40%. It is important to verify that your specific plan allows for this cash payment option, as some in-network contracts may still require you to meet a deductible before the lower negotiated rate applies.
To ensure you receive the best possible price, you should contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% for upfront payment. Since over 80% of hospital bills contain errors, it is advisable to request a full itemized CPT-coded statement before signing any consent waivers or making a payment, ensuring no services were unbundled or incorrectly charged. While the facility is a voluntary non-profit acute care hospital, always confirm your out-of-network status and avoid signing away your rights to dispute balance billing unless you have explicitly verified that the service is covered under your plan's network agreements.