CMS Price Transparency Data

Inguinal hernia repair

Facility: Anderson Hospital

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $3,775
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.03x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Anderson Hospital is $3,775. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 1.03x the Medicare baseline. Located in 6800 State Route 162, Maryville, IL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,775

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%)
Insurance Median: $3,775 (103%)
Ins. Median: $3,775 (103% 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.

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
Tricare $545 - $6,140 15%
Humana $553 - $3,775 15%
Medicare (plans) $553 - $3,775 15%
UnitedHealthcare $553 - $3,775 15%
Medicaid / KanCare $752 - $4,423 21%
Work Comp $1,138 - $6,860 31%
Aetna $3,775 103%
Essence $3,837 - $3,952 105%
Devoted Health Ppo $3,851 105%
Clear Springs Health $3,889 106%
Ambetter / Centene $5,563 152%
Blue Choice $5,563 152%
Blue Cross Blue Shield $6,640 182%
Hopetrust $9,592 262%
Self Pay $25,000 683%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6800 State Route 162, Maryville, IL 62062
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals