Total hip replacement
Facility: University Of Kansas Hospital
Billing Code: 27130 (CPT)
- CPT Billing Code: 27130
- Insurance Median: $11,987
- Cash Discount Price: $18,158
- vs. Medicare Baseline: 0.91x 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 |
|---|---|---|
| Prime Health Services [503999912] | $3,089 | 24% |
| Alt Bnsf Railway Co [503301503] | $3,089 | 24% |
| Gallagher Bassett [5032000103] | $3,089 | 24% |
| Workers Comp [503999901] | $3,089 - $11,987 | 24% |
| Sedgwick Claims Management Services [53201618] | $3,089 | 24% |
| UnitedHealthcare | $8,509 - $19,179 | 65% |
| Medicaid / KanCare | $8,509 | 65% |
| Blue Cross Blue Shield | $8,509 - $25,711 | 65% |
| Devoted [503200068] | $11,987 | 91% |
| Tricare | $11,987 | 91% |
| Ku Athletics [503200094] | $11,987 | 91% |
| Aetna | $11,987 - $16,781 | 91% |
| Triwest [503201703] | $11,987 | 91% |
| Lasso Healthcare [503999926] | $11,987 | 91% |
| Humana | $11,987 - $12,226 | 91% |
| Medicare (plans) | $11,987 - $12,226 | 91% |
| Allwell [503200078] | $12,346 | 94% |
| American Health Plans [503200968] | $12,586 | 96% |
| Centurion [5032000966] | $15,583 | 119% |
| Ambetter / Centene | $20,377 | 155% |
| Wellfit [503301514] | $22,775 | 174% |
| Centivo [5032000982] | $22,775 | 174% |
| Oscar [503201609] | $22,775 | 174% |
| 6 Degrees Health [503999050] | $23,374 - $29,967 | 178% |
| Alt Wppa [5032000964] | $23,973 | 183% |
| Occunet [503999930] | $25,172 | 192% |
| Fort Hays State Student Athletes [5032000960] | $25,172 | 192% |
| Multiplan [503200057] | $32,364 | 247% |
| Claimdoc [503301509] | $32,364 | 247% |
| Advanced Medical Pricing Solutions [503301513] | $35,960 | 274% |
Consumer Guidance & Cost Commentary
For the CPT code 27130 (Total hip replacement) at University Of Kansas Hospital, the facility's negotiated rates range from $3,089 to $35,960 across 30 payers, with a median negotiated rate of $11,987. This median is significantly lower than the facility's gross charge of $90,789, reflecting standard insurance contracts that cap costs for members. However, patients should be aware that cash-pay options are often more economical; the cash median price is $18,158, which is notably higher than the median negotiated rate for many insurers. In cases where a patient's insurance deductible has not been met, or if their plan's negotiated rate exceeds the cash price, paying out-of-pocket upfront can result in lower total costs. To secure these lower rates, patients must explicitly request "self-pay" or "prompt-pay" discounts before scheduling, as default billing systems may automatically submit claims to insurance, voiding any cash agreement.
The facility's pricing is benchmarked against Medicare, which sets a fixed reimbursement rate of $13,116.76 for this procedure. The cash median of $18,158 represents a markup of approximately 1.41 times the Medicare rate, while the median negotiated rate of $11,987 is roughly 0.91 times the Medicare amount, indicating that many insurance contracts align closely with or fall below the federal baseline. It is important to note that while the facility is an Acute Care Hospital in Kansas City, KS, with a government ownership structure, the specific county or state average data was not provided in the available