Inguinal hernia repair
Facility: St. Catherine Hospital - Garden City
Billing Code: 49505 (CPT)
- CPT Billing Code: 49505
- Insurance Median: $506
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.14x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicare (plans) | $458 - $506 | 13% |
| Blue Cross Blue Shield | $458 - $4,883 | 13% |
| Aetna | $458 - $506 | 13% |
| Cigna | $458 - $506 | 13% |
| UnitedHealthcare | $458 - $506 | 13% |
| Humana | $458 - $506 | 13% |
| Kansas Health | $458 | 13% |
| Kaiser | $458 - $506 | 13% |
| Devoted Health | $506 | 14% |
| Innovage | $506 | 14% |
Consumer Guidance & Cost Commentary
For the CPT code 49505 (Inguinal hernia repair) at St. Catherine Hospital - Garden City, the negotiated rates across ten payers range from $458 to $506, with a median negotiated amount of $506. This commercial rate is significantly higher than the Medicare benchmark of $3,657.95, reflecting the typical administrative markup inherent in insurance contracts. While the facility is a voluntary non-profit church-owned acute care hospital in Garden City, KS (ZIP 67846), patients should be aware that cash-pay options are not listed in this dataset. However, for individuals with high-deductible plans, paying cash directly can sometimes result in lower out-of-pocket costs if the insurance negotiated rate exceeds the facility's cash price, making it essential to request a self-pay or prompt-pay discount before scheduling any procedures.
To avoid unexpected costs, patients should verify their specific plan's allowed amount, as commercial rates vary by insurer and can differ substantially from one another. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, summary bills often obscure individual line items, potentially hiding unbundled charges or services not rendered. Consumers are advised to demand a full itemized CPT-coded bill before finalizing payment and to dispute any discrepancies in writing rather than accepting verbal assurances. By comparing the facility's rates against the Medicare baseline and actively seeking prompt-pay discounts, patients can ensure they are paying a fair price aligned with the true cost of care rather than inflated chargemaster lists.