Total hip replacement
Facility: Girard Medical Center
Billing Code: 27130 (CPT)
- CPT Billing Code: 27130
- Insurance Median: $1,058
- Cash Discount Price: $2,472
- vs. Medicare Baseline: 0.08x 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 | $1,058 | 8% |
| Kansas Superior Select-All Plans | $1,058 | 8% |
| Blue Cross Blue Shield | $1,058 | 8% |
| Ambetter / Centene | $1,058 | 8% |
| Medicare (plans) | $1,058 | 8% |
| UnitedHealthcare | $1,058 - $1,600 | 8% |
| Aetna | $1,058 | 8% |
| Uhhis-All Plans | $1,600 | 12% |
| Multiplan-All Plans | $3,811 | 29% |
Consumer Guidance & Cost Commentary
For a total hip replacement at Girard Medical Center in Girard, KS, the facility's cash median rate of $2,472 is significantly lower than the negotiated rates paid by most major insurers, which range from $1,058 to $3,811 depending on the plan. While the facility is a Critical Access Hospital with a government ownership structure, patients should be aware that commercial insurance contracts often result in higher out-of-pocket costs than paying cash directly. This is particularly relevant for individuals with high-deductible plans, where the cash price may be more affordable than the insurance negotiated rate, provided the patient's deductible has not yet been met. To minimize costs, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can further reduce the final bill.
When evaluating the cost of this procedure, it is essential to compare rates against the Medicare benchmark rather than the hospital's full chargemaster list. The Medicare allowed amount for this service is $13,116.76, which serves as a scientifically validated baseline for the true cost of care; however, the commercial negotiated rates observed here are notably lower than the gross charge of $4,120, reflecting the impact of insurance contracts. If a patient receives a bill that exceeds the negotiated amount, they may be facing balance billing, which is generally prohibited for out-of-network services at in-network facilities under the No Surprises Act. Consumers should request a detailed, itemized bill to verify that all charges are accurate and that no unbundled codes or services not rendered have inflated the total, ensuring they are not paying for unnecessary administrative fees or errors.