Total hip replacement
Facility: Overland Park Reg Med Ctr
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 |
|---|---|---|
| Universal Healthcare | $1,995 | 15% |
| Nhc Advantage | $2,550 | 19% |
| Humana | $3,738 - $14,000 | 28% |
| United | $8,509 - $38,731 | 65% |
| Amerigroup | $8,509 | 65% |
| Healthyblue | $8,679 | 66% |
| Medicaid / KanCare | $8,764 | 67% |
| Aetna | $8,849 - $31,756 | 67% |
| Unicare | $8,849 | 67% |
| Home State Health Plan | $11,517 - $17,276 | 88% |
| Cigna | $12,763 - $32,176 | 97% |
| Devoted Health | $15,194 | 116% |
| Oscar | $19,036 | 145% |
| Ambetter / Centene | $21,244 | 162% |
| Blue Cross Blue Shield | $25,858 | 197% |
| Wppa Providrs Care Network | $28,000 | 213% |
| Multiplan | $43,592 | 332% |
Consumer Guidance & Cost Commentary
For a total hip replacement at Overland Park Reg Med Ctr in Kansas, the facility's negotiated rates range from $1,995 to $43,592 across 17 different payers, with a median negotiated amount of $14,000. While the facility is located in Overland Park (ZIP 66215), the provided data does not include specific county or state average benchmarks for comparison. It is important to note that commercial negotiated rates often exceed the true cost of care; fair pricing is typically defined as 120% to 150% of the Medicare rate, which stands at $13,116.76 for this procedure. Because administrative structures and contract dynamics can inflate these rates, patients should verify their specific in-network allowed amounts before scheduling to ensure they are not paying above the fair market value.
Patients should be aware that cash-pay options can sometimes result in lower out-of-pocket costs than insurance claims, particularly for those with high-deductible plans where the insurance negotiated rate exceeds the cash price. The facility offers a prompt-pay discount for upfront payments, which can bypass costly insurance billing cycles and administrative overhead. To maximize savings, patients should explicitly request self-pay or prompt-pay rates prior to check-in and sign a waiver of insurance submission to prevent automatic claims that would void the cash agreement. Additionally, if a balance bill arises from out-of-network ancillary services, patients should dispute the charge with their insurer and request a No Surprises Act audit rather than paying immediately, as federal protections often ban these surprise bills for care received at in-network facilities.