Total hip replacement
Facility: St. Catherine Hospital - Garden City
Billing Code: 27130 (CPT)
- CPT Billing Code: 27130
- Insurance Median: $1,243
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.09x 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 |
|---|---|---|
| Kaiser | $1,130 - $1,243 | 9% |
| Kansas Health | $1,130 | 9% |
| Aetna | $1,130 - $34,485 | 9% |
| UnitedHealthcare | $1,130 - $1,243 | 9% |
| Cigna | $1,130 - $1,243 | 9% |
| Blue Cross Blue Shield | $1,130 - $18,681 | 9% |
| Humana | $1,130 - $1,243 | 9% |
| Medicare (plans) | $1,130 - $1,243 | 9% |
| Innovage | $1,243 | 9% |
| Devoted Health | $1,243 | 9% |
| Direct To Employer | $19,725 | 150% |
| Peak Health | $26,474 | 202% |
Consumer Guidance & Cost Commentary
For a total hip replacement at St. Catherine Hospital in Garden City, KS, the negotiated rates for in-network insurance plans range from $1,130 to $1,243, with a median of $1,243. These contracted amounts are significantly lower than the facility's direct-to-employer rate of $19,725 and the highest negotiated rate of $26,474 found with Peak Health. While commercial insurance contracts cap costs at these levels, patients should be aware that cash-pay options may offer further savings; the data indicates no specific cash median was reported, but hospitals often provide self-pay or prompt-pay discounts that can reduce the final bill by 20% to 50% if paid upfront. It is crucial to verify your specific plan's allowed amount before scheduling, as some insurers may have different caps than the facility's general negotiated rate.
When reviewing your final statement, always request a full itemized bill rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as double-billing or unbundled codes that should be consolidated. If you receive a balance bill for the difference between the provider's chargemaster and your insurance payment, remember that the No Surprises Act generally protects you from these unexpected charges for emergency care and non-emergency services at in-network facilities. For context, the Medicare benchmark for this procedure is $13,116.76, which serves as a scientifically validated baseline for the true cost of care; commercial negotiated rates are typically higher than this benchmark due to administrative overhead, but fair pricing is often defined as 120% to 150% of the Medicare amount