CMS Price Transparency Data

Inguinal hernia repair

Facility: University of Iowa Health Care Medical Center Down

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $1,918
Cash Discount Price: $1,877
vs. Medicare Baseline: 0.52x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at University of Iowa Health Care Medical Center Down is $1,918. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,877. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.52x the Medicare baseline. Located in 500 E Market Street, Iowa City, IA.

Cash / Self-Pay

$1,877

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,918

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: $1,877 (51%)

Insurance Median: $1,918 (52%)

Cash: $1,877 (51% of Medicare)

Ins. Median: $1,918 (52% 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
Aetna	$464 - $4,359	13%
Iowa Total Care	$464 - $3,454	13%
Medical Associates	$464 - $1,959	13%
Molina Healthcare	$464	13%
UnitedHealthcare	$464 - $10,240	13%
Blue Cross Blue Shield	$468 - $3,354	13%
Healthpartners	$473 - $3,387	13%
Wellpoint (Amerigroup)	$487 - $3,487	13%
Immergrun	$670	18%
Aplos Health Plan	$1,183	32%
Midlands Choice	$1,349 - $1,587	37%
Quad City Community Healthcare	$1,353 - $2,012	37%
Oscar Health	$1,690	46%
Great River Health Systems	$1,877	51%
Sedgwick	$2,146	59%
Global Excel	$2,280	62%
Sanford Health Plan	$2,280	62%
Employee Benefit Systems	$2,360	65%
Sisco	$2,360	65%
Healthsmart	$2,414	66%
Hfn	$2,467	67%
Multiplan	$2,467	67%

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 $1,877.
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 University of Iowa Health Care Medical Center Down 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.