CMS Price Transparency Data

Inguinal hernia repair

Facility: The Queens Medical Center

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $5,191
Cash Discount Price: $18,571
vs. Medicare Baseline: 1.42x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at The Queens Medical Center is $5,191. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $18,571. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 1.42x the Medicare baseline. Located in 1301 Punchbowl St, Honolulu, HI.

Cash / Self-Pay

$18,571

Average discount available for prompt cash payment at this facility.

Insurance Median

$5,191

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$3,657.95

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $3,657.95 (100%)

Cash / Self-Pay: $18,571 (508%)

Insurance Median: $5,191 (142%)

Cash: $18,571 (508% of Medicare)

Ins. Median: $5,191 (142% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $3,657.95 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Alohacare	$258 - $7,137	7%
Hmsa	$468 - $7,576	13%
UnitedHealthcare	$1,550 - $7,137	42%
Kaiser	$4,209 - $19,983	115%
Ohana Care	$4,209 - $7,137	115%
Hawaii Community Health Alliance	$4,444 - $4,699	121%
Hawaii Mainland Administrators	$4,444 - $5,075	121%
Hawaii Western Management Group	$4,699	128%
University Health Alliance	$5,191	142%
Hawaii Laborers	$5,869	160%
Mdx Hawaii	$6,107	167%
Seven Corners	$7,787 - $13,203	213%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $18,571.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 49505.

Insurance In-Network Protection Plan

Contact your insurance company to confirm The Queens Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 49505.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.