CMS Price Transparency Data

Total hip replacement

Facility: St Joseph Medical Center

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27130
  • Insurance Median: $12,796
  • Cash Discount Price: $12,796
  • vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a Total hip replacement at St Joseph Medical Center is $12,796. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $12,796. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.98x the Medicare baseline. Located in 1000 Carondelet Dr, Kansas City, MO.
Cash / Self-Pay
$12,796

Average discount available for prompt cash payment at this facility.

Insurance Median
$12,796

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$13,116.76

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $13,116.76 (100%)
Cash / Self-Pay: $12,796 (98%)
Insurance Median: $12,796 (98%)
Cash: $12,796 (98% of Medicare)
Ins. Median: $12,796 (98% of 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.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Aetna $5,440 - $12,796 41%
Medicaid / KanCare $10,969 84%
Home State $12,504 - $20,474 95%
UnitedHealthcare $12,724 - $24,270 97%
Cigna $12,796 98%
Medicare (plans) $12,796 - $13,436 98%
Pace Kc (Swope Health Services) $12,796 98%
Tricare $12,796 98%
Veterans Evaluation Services $12,796 98%
Healthy Blue $13,436 - $14,588 102%
Kansas Superior $13,436 102%
Nhc Advantage $14,076 107%
Employer Direct Healthcare $17,915 137%
Blue Cross Blue Shield $20,474 - $23,673 156%
6 Degrees $24,270 185%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Carondelet Dr, Kansas City, MO 64114
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals