Total hip replacement
Facility: Saint Luke'S South Hospital
Billing Code: 27130 (CPT)
- CPT Billing Code: 27130
- Insurance Median: $11,200
- Cash Discount Price: $39,750
- vs. Medicare Baseline: 0.85x 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 |
|---|---|---|
| Medicaid / KanCare | $8,509 - $16,453 | 65% |
| UnitedHealthcare | $11,133 - $18,590 | 85% |
| Humana | $11,200 - $24,575 | 85% |
| Cigna | $11,442 | 87% |
| Commercial-Contracted [8000] | $12,551 | 96% |
Consumer Guidance & Cost Commentary
For a total hip replacement at Saint Luke's South Hospital in Overland Park, Kansas, the facility's cash median rate of $39,750 is significantly lower than the negotiated rates paid by major insurers like UnitedHealthcare ($11,133 to $18,590) and Humana ($11,200 to $24,575). While the facility's negotiated rate of $11,200 appears lower than the cash price, this comparison can be misleading if your insurance plan has a high deductible; in such cases, paying the cash price upfront may result in lower out-of-pocket costs compared to your insurance paying its negotiated rate while you cover the remainder. It is crucial to verify your specific deductible status before scheduling, as assuming that in-network coverage automatically provides the best price can lead to unexpected financial burdens if your plan has not yet met its threshold.
Patients should be aware that the facility's gross charge of $66,251 represents the full list price, which is substantially higher than the Medicare benchmark of $13,117. Medicare serves as a reliable baseline for evaluating pricing markups, as commercial negotiated rates often exceed fair pricing benchmarks by a significant margin. If you receive a bill that includes charges for services not rendered, unbundled codes, or items that were cancelled, you have the right to request a formal itemized billing audit to identify errors before paying. Additionally, if you are billed for out-of-network services at this in-network facility, the No Surprises Act may protect you from balance billing, but you should dispute any surprise charges in writing rather than accepting summary bills or signing away your rights via consent waivers.