Total hip replacement
Facility: Menorah 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 |
|---|---|---|
| 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% |
| Unicare | $8,849 | 67% |
| Aetna | $8,849 - $31,756 | 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 the CPT code 27130 (Total hip replacement) at Menorah Medical Center in Overland Park, KS, the negotiated rates range from $1,995 to $43,592 across 17 different payers, with a median negotiated amount of $14,000. This facility's pricing structure is significantly higher than the national average, as the median negotiated rate is 1.1 times the Medicare benchmark of $13,116.76. While the facility is an acute care hospital with a proprietary ownership model, patients should be aware that commercial insurance contracts often include administrative overheads that inflate the baseline price by 20% to 40% compared to the true cost of care.
Because cash prices are not explicitly listed in the data, patients with high-deductible plans may find that paying out-of-pocket is more cost-effective than relying on insurance, which could result in balance billing if the allowed amount exceeds their coverage. It is crucial to request a "self-pay" or "prompt-pay" discount before scheduling any services, as hospitals typically offer fee reductions of 20% to 50% for upfront payments that bypass costly claims processing. Additionally, patients should avoid accepting summary bills and instead demand a full itemized CPT-coded statement to identify any unbundled charges or services not rendered, ensuring they are not paying for unnecessary components of the procedure.