Total hip replacement
Facility: Kansas Spine & Specialty Hospital, Llc
Billing Code: 27130 (CPT)
- CPT Billing Code: 27130
- Insurance Median: $11,773
- Cash Discount Price: $10,593
- vs. Medicare Baseline: 0.90x 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 |
|---|---|---|
| Humana | $11,537 | 88% |
| Aetna | $11,773 - $14,716 | 90% |
| Providrs Care Network | $11,773 | 90% |
| UnitedHealthcare | $11,773 - $14,245 | 90% |
| United Mine Workers Of America | $11,773 | 90% |
| Blue Cross Blue Shield | $11,773 - $32,362 | 90% |
| Lantern Specialty Care | $18,837 | 144% |
Consumer Guidance & Cost Commentary
For a total hip replacement at Kansas Spine & Specialty Hospital in Wichita, the cash median price is $10,593, which is lower than the facility's gross charge of $16,297. While the facility is a physician-owned acute care hospital, patients should be aware that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract structures. For instance, Blue Cross Blue Shield has a high-end negotiated rate of $32,362 across two plans, significantly higher than the cash price. If you have a high-deductible plan, paying the cash price upfront may result in lower out-of-pocket costs compared to your insurance's negotiated rate, provided you have sufficient funds to cover the difference before your deductible is met.
To ensure you are not overcharged, it is crucial to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Additionally, ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full within 30 days, bypassing costly insurance claims processing. While the data provided does not include specific county or state average comparisons for this procedure, always verify the facility's pricing against local benchmarks and ensure you understand the difference between the facility's chargemaster list and the actual Medicare benchmark of $13,116.76, which serves as a scientifically validated baseline for fair pricing.