Total hip replacement
Facility: Bob Wilson Memorial Hospital
Billing Code: 27130 (CPT)
- CPT Billing Code: 27130
- Insurance Median: $21,040
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.60x 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 |
|---|---|---|
| Blue Cross Blue Shield | $21,040 | 160% |
Consumer Guidance & Cost Commentary
For a total hip replacement at Bob Wilson Memorial Hospital in Ulysses, Kansas, the negotiated rate for Blue Cross Blue Shield is $21,040, which matches the facility's median negotiated amount. This specific rate is significantly higher than the Medicare benchmark of $13,116.76, reflecting a markup of 160% above the federal baseline. While this facility is a Critical Access Hospital owned by a voluntary non-profit church, patients should be aware that cash-pay options may offer lower costs if their insurance negotiated rate exceeds the cash price. It is important to note that cash prices are not explicitly listed in this report, so patients with high-deductible plans might save money by paying upfront, provided they secure a "waiver of insurance submission" to avoid automatic claims processing that would void any potential cash discount.
When reviewing your final bill, always request a detailed, itemized statement rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as double-billing or unbundled codes. If you receive a balance bill for services not covered by your plan, remember that the No Surprises Act protects you from being charged the difference for emergency care or non-emergency services at in-network facilities. To ensure you are receiving fair pricing, compare the facility's rates against state and county averages, though specific county averages were not provided in this dataset. Finally, do not sign out-of-network cost waivers without reading them, and if you believe you are being overcharged, send a formal written audit dispute to the billing supervisor rather than resolving issues over the phone.