CMS Price Transparency Data

Inguinal hernia repair

Facility: Hammond Henry Hospital

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $1,506
Cash Discount Price: $2,464
vs. Medicare Baseline: 0.41x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at Hammond Henry Hospital is $1,506. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,464. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.41x the Medicare baseline. Located in 600 N College Avenue, Geneseo, IL.

Cash / Self-Pay

$2,464

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,506

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: $2,464 (67%)

Insurance Median: $1,506 (41%)

Cash: $2,464 (67% of Medicare)

Ins. Median: $1,506 (41% 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
Multiplan Phcs Adult	$90 - $2,464	2%
Multiplan Phcs Pediatric	$90 - $2,464	2%
Tricare	$478 - $715	13%
Aetna	$531 - $8,406	15%
Health Alliance Mcare Adv	$531 - $794	15%
Humana	$531 - $2,464	15%
UnitedHealthcare	$531 - $2,023	15%
Quad City Community Hc-All Plans	$541 - $1,369	15%
Blue Cross Blue Shield	$577 - $8,406	16%
Health Alliance-All Other Plans	$690 - $2,054	19%
Ambetter / Centene	$796 - $1,191	22%
Multiplan Pponext	$903 - $2,190	25%
Wellmark Of Ia-All Plans	$1,014 - $1,369	28%
Springfield Armory-All Plans	$1,035 - $1,780	28%
Multiplan-All Other Plans	$1,062 - $2,327	29%
Multiplan Integrated Hp	$2,054	56%
Osf Direct Access Network-All Plans	$2,190	60%
Corvel-All Plans	$2,464	67%
Healthsmart Adult-All Other Plans	$2,464	67%
Healthsmart Pediatric	$2,464	67%
Hfn-All Plans	$2,464	67%
Multiplan Beech Street	$2,464	67%
Usa Mco-All Plans	$2,464	67%
Meridian Health Plan-All Plans	$2,738 - $8,406	75%

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 $2,464.
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 Hammond Henry Hospital 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.