Total hip replacement
Facility: Children'S Mercy South
Billing Code: 27130 (CPT)
- CPT Billing Code: 27130
- Insurance Median: $2,346
- Cash Discount Price: $1,829
- vs. Medicare Baseline: 0.18x 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 |
|---|---|---|
| UnitedHealthcare | $1,168 - $2,590 | 9% |
| Healthy Blue | $1,246 - $1,812 | 9% |
| Medicaid / KanCare | $1,258 | 10% |
| Wppa Providrs Care | $1,493 | 11% |
| Healthlink | $1,669 | 13% |
| Health Midwest Comprehensive Care | $1,710 | 13% |
| Home State Health | $1,812 | 14% |
| American Healthcare Alliance | $1,825 | 14% |
| Quiktrip | $1,897 | 14% |
| Blue Cross Blue Shield | $1,918 - $2,484 | 15% |
| Medica | $2,221 | 17% |
| Wellfit/Centrus | $2,364 | 18% |
| Aetna | $2,418 - $2,849 | 18% |
| Centivo | $2,435 | 19% |
| Multiplan | $2,480 | 19% |
| Humana | $2,525 | 19% |
| Orscheln | $2,553 | 19% |
| Nebraska Furniture Mart | $2,574 | 20% |
| Mercy Health | $2,781 | 21% |
| Coxhealth Network | $2,819 | 21% |
| Cigna | $2,921 | 22% |
| Coventry Health Care Of Kansas | $3,057 | 23% |
| National Preferred Provider Network | $3,353 | 26% |
Consumer Guidance & Cost Commentary
For a total hip replacement at Children's Mercy South in Overland Park, Kansas, the cash price is $1,829, which is significantly lower than the facility's gross charge of $3,810 and the Medicare benchmark of $13,117. While commercial insurance plans negotiate rates ranging from $1,168 to $3,353, many in-network payers like Aetna and Humana have negotiated amounts that exceed the cash price. This pricing structure highlights a common billing principle where paying out-of-pocket can be more cost-effective for patients with high-deductible plans, as the insurance negotiated rate often includes administrative overhead that inflates the final bill. To maximize savings, patients should verify their specific plan's allowed amount before scheduling and consider requesting a "self-pay" or "prompt-pay" discount, which typically reduces the total cost by 20% to 50% if paid in full upfront.
When reviewing your final invoice, it is critical to request an itemized bill that breaks down every CPT code, supply, and service rather than accepting a summary total, as over 80% of hospital bills contain errors such as unbundled charges or services not rendered. Comparing the facility's rates to the state average provides a clear picture of pricing fairness; for this procedure, the cash rate of $1,829 is notably lower than the state average, suggesting the facility's pricing is competitive when paid directly. If you receive a balance bill for the difference between the provider's charge and your insurance payment, you may be protected under the No Surprises Act, which bans balance billing for out-of-network providers at in-network facilities. Always dispute