Total hip replacement
Facility: Republic County Hospital
Billing Code: 27130 (CPT)
- CPT Billing Code: 27130
- Insurance Median: $11,804
- Cash Discount Price: $9,623
- 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 |
|---|---|---|
| Rural Carriers-All Plans | $10,906 | 83% |
| Aetna | $11,547 | 88% |
| Meritain-All Plans | $11,547 | 88% |
| UnitedHealthcare | $11,804 | 90% |
| Midlands Choice-All Plans | $12,188 | 93% |
| Cigna | $12,188 | 93% |
| First Health-All Plans | $12,188 | 93% |
Consumer Guidance & Cost Commentary
For a total hip replacement at Republic County Hospital in Belleville, KS, the negotiated rates for major payers like UnitedHealthcare and Cigna range from $11,804 to $12,188, while the cash price is $9,623. This cash rate is significantly lower than the facility's gross charge of $12,830 and represents a substantial discount compared to the commercial negotiated rates. Patients with high-deductible plans may find it beneficial to pay the cash price directly, as the $9,623 amount is notably lower than the $11,804 median negotiated rate, potentially saving thousands of dollars before insurance coverage begins.
To maximize savings, patients should explicitly request "self-pay" or "prompt-pay" discounts before scheduling their visit, as billing systems often default to insurance processing once a card is on file. It is important to understand that while the facility is a Critical Access Hospital with a voluntary non-profit ownership, the commercial rates reflect the administrative costs and contract dynamics of insurance billing rather than the true cost of care. By comparing these figures to the Medicare benchmark of $13,116.76, it becomes clear that the cash price offers the most direct financial advantage for those without immediate insurance coverage or who wish to avoid the complexity of claims processing.