CMS Price Transparency Data

Inguinal hernia repair

Facility: Carle Richland Memorial Hospital

Billing Code: 49505 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$1,163

about 0.3× the $3,658 Medicare rate · typically $626–$3,538

modeled estimate · not a bill or quote

Medicare pays $3,658 Fair price $1,163 Cash price $4,274 Hospital's list price $4,274

How we calculate the fair BaseRate →

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$898 - $3,265	25%
Blue Cross Blue Shieldmajor	$898 - $2,992	25%
Aetnamajor	$898 - $3,565	25%
Cignamajor	$82	2%
Humanamajor	$898	25%
HealthLink	$2,778 - $2,992	76%
Meridian	$898	25%
Molina	$898 - $1,282	25%
WellCare	$898	25%

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 4,274), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 49505.

Insurance Before you use insurance

Call your insurance company to confirm Carle Richland Memorial Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 49505.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Carle Richland Memorial Hospital

Compare: Inguinal hernia repair at other IL hospitals

Insurance negotiated median for the same procedure, sorted lowest first.