Total hip replacement
Facility: Cloud County Health Center
Billing Code: 27130 (CPT)
- CPT Billing Code: 27130
- Insurance Median: $1,428
- Cash Discount Price: $979
- vs. Medicare Baseline: 0.11x 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 |
|---|---|---|
| Pponext-All Plans | $532 - $2,126 | 4% |
| Mpi-All Plans | $1,428 | 11% |
Consumer Guidance & Cost Commentary
For a total hip replacement at Cloud County Health Center in Concordia, KS, the cash median price is $979.00, which is lower than the facility's negotiated rate of $1,428.00 and the median paid amount of $1,329.00. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that commercial insurance plans often pay negotiated rates that exceed cash prices. For individuals with high-deductible plans, paying the cash price of $979.00 upfront can be more cost-effective than relying on insurance, as the negotiated rates for payers like Pponext-All Plans and Mpi-All Plans range from $1,428.00 to $2,126.00. It is advisable to contact the hospital directly to confirm "self-pay" or "prompt-pay" discounts, which can further reduce the final bill by bypassing administrative claim processing costs.
When reviewing your final invoice, ensure you request a detailed itemized bill rather than accepting a summary statement, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Comparing this procedure to the Medicare benchmark of $13,116.76 reveals that the commercial negotiated rates are significantly higher than the federal baseline, highlighting the importance of understanding the markup involved in commercial contracts. If you encounter a large bill after receiving care, do not pay immediately; instead, dispute any errors in writing to the billing supervisor and verify that no balance billing has occurred, as the No Surprises Act protects patients from unexpected charges for out-of-network services at in-network