Inguinal hernia repair
Facility: Providence Medical Center
Billing Code: 49505 (CPT)
- CPT Billing Code: 49505
- Insurance Median: $3,542
- Cash Discount Price: $3,373
- vs. Medicare Baseline: 0.97x 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 | $580 - $4,081 | 16% |
| Comp Alliance - Fka Compresults Worker Compensation | $1,036 | 28% |
| UnitedHealthcare | $1,121 - $6,375 | 31% |
| Medicaid / KanCare | $1,121 | 31% |
| Healthy Blue | $1,143 - $3,542 | 31% |
| Celtic | $1,143 - $5,397 | 31% |
| Midland Care Connection | $3,373 | 92% |
| Medicare (plans) | $3,373 | 92% |
| Tricare | $3,373 | 92% |
| Cigna | $3,373 | 92% |
| Kansas Superior Select | $3,542 | 97% |
| Corizon | $4,385 | 120% |
| Well Path Prison | $4,722 | 129% |
| Employer Direct Healthcare | $4,722 | 129% |
| Centurion | $5,060 | 138% |
| Naphcare | $5,228 | 143% |
| Blue Cross Blue Shield | $5,397 - $6,240 | 148% |
| Oha Networks | $5,648 | 154% |
| Worker Compensation | $5,822 | 159% |
Consumer Guidance & Cost Commentary
For an inguinal hernia repair at Providence Medical Center in Kansas City, KS, the cash price of $3,373 is significantly lower than the facility's negotiated rates, which range from $1,121 to $6,240 across 19 different payers. While Medicare sets a benchmark of $3,657.95 for this procedure, the cash rate aligns closely with the state average, making it a potentially more affordable option for patients with high-deductible plans or those without insurance. Although the facility's cash price is lower than the median negotiated amount of $3,542, patients should verify their specific plan's deductible status before assuming insurance will result in lower out-of-pocket costs, as some commercial contracts may exceed the cash price.
To ensure you are receiving the most accurate and fair billing, it is crucial to request a full itemized bill rather than accepting a summary invoice that obscures individual charges. Since over 80% of hospital bills contain errors, such as unbundled codes or services not rendered, a line-by-line review is the most effective way to identify and dispute mistakes. Additionally, if you choose to pay out-of-pocket, ask the billing department about prompt-pay discounts, which can reduce the total by 20% to 50% if settled within 30 days, bypassing the administrative costs associated with insurance claims processing.