Total hip replacement
Facility: Wesley Medical Center
Billing Code: 27130 (CPT)
- CPT Billing Code: 27130
- Insurance Median: $14,000
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.07x 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 | $8,509 | 65% |
| Medicaid / KanCare | $8,764 | 67% |
| Aetna | $8,790 - $13,523 | 67% |
| Amerigroup | $8,849 | 67% |
| Ambetter / Centene | $10,000 | 76% |
| Humana | $14,000 | 107% |
| Wppa | $14,622 - $20,889 | 111% |
| Devoted Health | $14,788 | 113% |
| Blue Cross Blue Shield | $21,672 | 165% |
| United | $24,722 | 188% |
Consumer Guidance & Cost Commentary
For a total hip replacement at Wesley Medical Center in Wichita, KS, the facility's negotiated rates range from $8,509 to $24,722 depending on your specific insurance plan. While the lowest negotiated rate of $8,509 from UnitedHealthcare is significantly lower than the facility's median negotiated rate of $14,000, it is still higher than the Medicare benchmark of $13,116.76. This indicates that even the most favorable in-network contracts often exceed the federal government's calculated cost baseline. Patients with high-deductible plans or those without insurance may find it more cost-effective to pay the cash price directly, as commercial negotiated rates frequently include administrative markups that do not apply to self-pay patients. It is important to verify your specific plan's allowed amount before scheduling, as rates vary widely across the ten payers listed, with Humana and Blue Cross Blue Shield showing the highest negotiated amounts in this dataset.
To ensure you are not overcharged, always request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. If you receive a surprise bill for out-of-network services, you may be protected under the No Surprises Act, which prohibits balance billing for emergency care and non-emergency services at in-network facilities. Additionally, ask the hospital about "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full upfront, bypassing the costly insurance claims process. Since the facility is a proprietary acute care hospital, you should contact them directly to confirm if self-pay or prompt-pay options