CMS Price Transparency Data

Inguinal hernia repair

Facility: Rush Memorial Hospital

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $504
Cash Discount Price: $563
vs. Medicare Baseline: 0.14x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at Rush Memorial Hospital is $504. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $563. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.14x the Medicare baseline. Located in 1300 N Main St, Rushville, IN.

Cash / Self-Pay

$563

Average discount available for prompt cash payment at this facility.

Insurance Median

$504

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: $563 (15%)

Insurance Median: $504 (14%)

Cash: $563 (15% of Medicare)

Ins. Median: $504 (14% 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
Cigna	$375	10%
Health Net	$375	10%
UnitedHealthcare	$400 - $460	11%
Caresource Mcr Adv	$460	13%
Aetna	$464 - $504	13%
Humana	$464 - $467	13%
Blue Cross Blue Shield	$473 - $568	13%
Today'S Option Mcr Adv-All Plans	$473	13%
Viant Beech St Mcr Adv	$473	13%
My True Advantage - All Plans	$483	13%
Consumers Life Ins-All Plans	$504	14%
Coventry/First Health-All Plans	$525	14%
Phcs-All Plans	$581	16%
Caresource Marketplace-All Other Plans	$621	17%
Multiplan-All Plans	$794	22%
Encore Health Services-All Plans	$865	24%
Siho-All Plans	$865	24%

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 $563.
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 Rush Memorial 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.