Total hip replacement
Facility: Amberwell Atchison Association
Billing Code: 27130 (CPT)
- CPT Billing Code: 27130
- Insurance Median: $1,417
- Cash Discount Price: $2,209
- 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 |
|---|---|---|
| Humana | $1,058 - $1,417 | 8% |
| UnitedHealthcare | $1,058 - $1,442 | 8% |
| Superior Select Mcr Adv - All Plans | $1,058 | 8% |
| Triwest - All Plans | $1,058 | 8% |
| Va Ccn - All Plans | $1,058 | 8% |
| Centrus Health Direct - All Plans | $1,269 | 10% |
| Cigna | $1,470 | 11% |
| Aetna | $1,491 | 11% |
| Wppa Providrs Care - All Plans | $1,662 | 13% |
| Ambetter / Centene | $1,662 | 13% |
| Oscar - All Plans | $1,692 | 13% |
| Multiplan - All Plans | $2,010 | 15% |
Consumer Guidance & Cost Commentary
Amberwell Atchison Association, located at 800 Raven Hill Drive in Atchison, Kansas, lists a cash median price of $2,209 for a total hip replacement. This cash rate is significantly lower than the facility's gross charge of $2,209, indicating no markup for self-pay patients, though patients should verify if "self-pay" or "prompt-pay" discounts are available upon scheduling. While the facility is a voluntary non-profit critical access hospital, the cash price does not reflect the commercial rates charged to insured patients, which can vary widely depending on the specific insurance plan.
For patients with commercial insurance, the negotiated rates range from $1,058 to $2,010 across 12 payers, with UnitedHealthcare and Cigna offering the highest rates at $1,442 and $1,470 respectively. These negotiated amounts are notably higher than the cash price, meaning patients with high-deductible plans might save money by paying the cash rate directly if the insurer's allowed amount exceeds the cash charge. Additionally, the Medicare amount of $13,116.76 serves as a benchmark for the true cost of care, revealing that commercial rates are marked up relative to this federal baseline. Patients are encouraged to request an itemized billing audit to ensure all charges are accurate and to avoid unexpected balance bills, particularly if any ancillary services are provided by out-of-network providers.