Total hip replacement
Facility: Wamego Health Center
Billing Code: 27130 (CPT)
- CPT Billing Code: 27130
- Insurance Median: $8,509
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.65x 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 |
|---|---|---|
| UnitedHealthcare | $696 - $8,509 | 5% |
| Aetna | $723 - $8,849 | 6% |
| Medicaid / KanCare | $723 - $8,849 | 6% |
| Providrs Care | $1,563 | 12% |
| Blue Cross Blue Shield | $20,703 - $21,792 | 158% |
Consumer Guidance & Cost Commentary
For a total hip replacement at Wamego Health Center in Wamego, Kansas, the negotiated rates paid by major insurers like UnitedHealthcare and Aetna range from $723 to $8,849, with a median negotiated amount of $8,509. This commercial rate is significantly higher than the Medicare benchmark of $13,116.76, which serves as the federal baseline for the true cost of care. While commercial contracts often include administrative overhead that can inflate prices by 20% to 40% above the Medicare rate, the facility's specific negotiated ceiling for this service remains well below the upper end of the state average for this procedure. Patients with high-deductible plans should note that paying cash directly could sometimes result in lower out-of-pocket costs if the facility's self-pay rate is lower than the patient's insurance allowed amount, though the facility's cash median is not currently listed.
To ensure you are not overpaying, it is critical to request a full itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Do not accept a summary bill that only shows broad categories like "Laboratory" or "Pharmacy," as these can obscure individual price gouging; instead, demand a line-by-line statement of charges to identify any double-billing or unbundled components. Additionally, ask the billing department about prompt-pay discounts, which can reduce the total bill by 20% to 50% if you pay in full upfront, bypassing the costly claims processing cycle that insurers typically handle. Finally, verify your deductible status before scheduling, as