Inguinal hernia repair
Facility: Labette Health
Billing Code: 49505 (CPT)
- CPT Billing Code: 49505
- Insurance Median: $982
- Cash Discount Price: $785
- vs. Medicare Baseline: 0.27x 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 |
|---|---|---|
| Aetna | $444 | 12% |
| Uhccp | $452 | 12% |
| Kansas Superior Select | $482 - $3,362 | 13% |
| Montgomery County | $497 - $5,973 | 14% |
| Medicaid / KanCare | $505 - $3,264 | 14% |
| Multiplan | $954 | 26% |
| Health Partners Of Kansas, Inc | $1,010 | 28% |
| Choicecare (First Health Network) | $1,010 | 28% |
| Ambetter / Centene | $1,122 | 31% |
| UnitedHealthcare | $3,264 | 89% |
| Blue Cross Blue Shield | $3,264 - $4,120 | 89% |
| Wellcare | $3,264 | 89% |
| Humana | $3,264 | 89% |
Consumer Guidance & Cost Commentary
For this inguinal hernia repair at Labette Health in Parsons, KS, the facility's cash price of $785.00 is significantly lower than the gross charge of $1,122.00 and sits below the state average of $1,122.00. While commercial payers like Aetna and Uhccp have negotiated rates of $444 and $452 respectively, many other insurers, including UnitedHealthcare and Blue Cross Blue Shield, have negotiated rates as high as $3,264 to $4,120. Because these negotiated rates often exceed the cash price, patients with high-deductible plans or those without insurance may save money by paying the cash rate directly. It is important to verify your specific plan's allowed amount before scheduling, as some in-network contracts can result in higher out-of-pocket costs than self-pay options.
To ensure you are not overcharged, request a full itemized bill that lists every CPT code and service rendered, as summary bills often hide unbundled charges or services not received. If you receive a balance bill for the difference between the provider's full charge and your insurance payment, you may have rights under the No Surprises Act, which prohibits balance billing for emergency care and non-emergency services at in-network facilities. Additionally, ask the billing department about prompt-pay discounts, which can reduce the total cost by 20% to 50% if you settle the account upfront, bypassing the administrative costs associated with insurance claims processing.