CMS Price Transparency Data

Inguinal hernia repair

Facility: Deaconess Illinois Crossroads

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $1,189
Cash Discount Price: $616
vs. Medicare Baseline: 0.33x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at Deaconess Illinois Crossroads is $1,189. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $616. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.33x the Medicare baseline. Located in 8 Doctors Park Rd, Mount Vernon, IL.

Cash / Self-Pay

$616

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,189

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: $616 (17%)

Insurance Median: $1,189 (33%)

Cash: $616 (17% of Medicare)

Ins. Median: $1,189 (33% 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	$387 - $3,752	11%
Blue Cross Blue Shield	$387 - $3,679	11%
Meridian Health Plan	$387 - $3,679	11%
Molina Healthcare Of Illinois	$387 - $3,716	11%
Wellcare	$387 - $3,679	11%
Humana	$516 - $3,679	14%
Mytru Advantage	$516 - $3,679	14%
Umwa	$516 - $3,679	14%
UnitedHealthcare	$516 - $3,679	14%
Self-Pay	$616	17%
Cigna	$685	19%
Alliance Coal	$712 - $6,070	19%
Alter-Net Medical Services, Inc.	$825 - $10,484	23%
Noncontracted	$825 - $5,886	23%
Deaconess Onecare	$1,058	29%
Prime Health Services	$1,321	36%
Guardian Resources, Inc.	$1,479	40%
Healthcare'S Finest Network (Hfn)	$1,497	41%
Medicalcontrol Network Solutions	$1,497	41%
National Provider Network	$1,497	41%
Three Rivers Provider Network	$1,532	42%
Beech Street	$1,550	42%
Care Improvement Plus	$3,752	103%
Hope Trust	$10,484	287%

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 $616.
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 Deaconess Illinois Crossroads 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.