Total hip replacement
Facility: Kingman Healthcare Center
Billing Code: 27130 (CPT)
- CPT Billing Code: 27130
- Insurance Median: $1,113
- Cash Discount Price: Unavailable
- 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 |
|---|---|---|
| Medicaid / KanCare | $1,113 | 8% |
| Healthy Blue | $1,113 | 8% |
| Triwest | $1,142 | 9% |
Consumer Guidance & Cost Commentary
For a total hip replacement at Kingman Healthcare Center in Kingman, KS, the facility's negotiated rates range from $1,113 to $1,142 depending on the payer, with Medicaid/KanCare and Healthy Blue both settling at $1,113. These contracted amounts are significantly lower than the Medicare benchmark of $13,116.76, reflecting the standard pricing dynamics where commercial contracts cap charges well below federal reimbursement levels. While the facility is a voluntary non-profit Critical Access Hospital, patients should note that cash-pay options are not listed in this report; however, it is always advisable to inquire directly with the hospital about self-pay or prompt-pay discounts before scheduling, as paying upfront can sometimes result in lower out-of-pocket costs compared to insurance negotiated rates.
It is important to understand that these negotiated rates represent the maximum amount an insurance plan will pay, not necessarily the final amount you owe. If your insurance deductible has not been met, you may be responsible for the full negotiated amount, which could be substantially higher than the cash price if one were available. Furthermore, because this is an in-network facility, you are protected under the No Surprises Act from balance billing for emergency or non-emergency services from out-of-network providers at the hospital. To ensure you receive the most accurate pricing, always request an itemized bill before paying, as summary invoices can obscure individual charges, and verify that all services rendered match the detailed CPT codes on your statement to avoid errors or double-billing.