Inguinal hernia repair
Facility: Wesley Medical Center
Billing Code: 49505 (CPT)
- CPT Billing Code: 49505
- Insurance Median: $3,362
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.92x 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 |
|---|---|---|
| Usa Managed Care | $1,004 | 27% |
| UnitedHealthcare | $1,121 | 31% |
| Medicaid / KanCare | $1,154 | 32% |
| Aetna | $1,166 - $4,874 | 32% |
| Amerigroup | $1,166 | 32% |
| Blue Cross Blue Shield | $3,362 | 92% |
| First Health | $5,531 | 151% |
| Multiplan | $5,764 | 158% |
| United | $5,766 | 158% |
Consumer Guidance & Cost Commentary
For an inguinal hernia repair at Wesley Medical Center in Wichita, KS, the median negotiated rate is $3,362, while the Medicare benchmark amount for this procedure is $3,657.95. This facility, a proprietary acute care hospital, reports a ratio of 0.9 relative to Medicare, indicating its negotiated rates are slightly below the federal baseline. Although the data does not list a specific cash or county average for this procedure, the absence of a cash median suggests that self-pay pricing is not explicitly disclosed in this dataset, making it important for patients to directly inquire about self-pay or prompt-pay discounts before scheduling.
When comparing payer-specific allowed amounts, UnitedHealthcare and Amerigroup both have a single plan with a rate of $1,121 and $1,166 respectively, while Aetna shows a range from $1,166 to $4,874 across four different plans. The highest negotiated rates are observed with Multiplan and First Health at $5,764 and $5,531, whereas Medicaid/KanCare and Blue Cross Blue Shield show single rates of $1,154 and $3,362. Because commercial negotiated rates often include administrative processing costs that can inflate prices by 20% to 40% compared to Medicare benchmarks, patients with high-deductible plans should verify their out-of-pocket obligations. It is also advisable to request an itemized billing audit if a summary bill is received, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered, which could significantly reduce the final amount owed.