Total hip replacement
Facility: Kansas City Orthopaedic Institute
Billing Code: 27130 (CPT)
- CPT Billing Code: 27130
- Insurance Median: $11,681
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.89x 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 |
|---|---|---|
| Blue Cross Blue Shield | $8,182 - $13,114 | 62% |
| UnitedHealthcare | $10,744 - $11,681 | 82% |
| Aetna | $11,681 | 89% |
| Cigna | $12,104 - $14,000 | 92% |
| Medica | $16,800 | 128% |
| Self Pay | $19,000 | 145% |
Consumer Guidance & Cost Commentary
For a total hip replacement at the Kansas City Orthopaedic Institute in Leawood, KS, the facility's negotiated rates range from $8,182 to $19,000 depending on the insurance carrier, with a median negotiated amount of $11,681. This facility is owned by physicians and operates as an acute care hospital. It is important to note that while commercial insurance contracts set a ceiling on what payers will reimburse, these negotiated rates often exceed the actual cost of care. For instance, the Self Pay rate is listed at $19,000, which is significantly higher than the Medicare benchmark of $13,116.76. Patients with high-deductible plans should be aware that paying cash upfront might result in a lower out-of-pocket cost than their insurance would allow, as the cash price can sometimes be cheaper than the insurance negotiated rate. Additionally, patients should explicitly ask the billing department about "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full within a short window, bypassing the administrative costs associated with insurance claims processing.
When reviewing your final invoice, it is crucial to request an itemized bill that breaks down every service by its specific CPT code rather than accepting a summary total. Over 80% of hospital bills contain errors, including unbundled charges where components of a procedure are billed separately, or services that were never rendered. If you receive a large bill, do not dispute errors verbally; instead, send a formal written audit dispute to the billing supervisor to ensure corrections are documented. Furthermore, compare the facility's pricing against state and county averages to understand