Inguinal hernia repair
Facility: Overland Park Reg Med Ctr
Billing Code: 49505 (CPT)
- CPT Billing Code: 49505
- Insurance Median: $4,698
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.28x 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 |
|---|---|---|
| Amerigroup | $1,121 | 31% |
| United | $1,121 - $6,988 | 31% |
| Healthyblue | $1,143 | 31% |
| Medicaid / KanCare | $1,154 | 32% |
| Unicare | $1,166 | 32% |
| Aetna | $1,166 - $12,237 | 32% |
| Home State Health Plan | $3,159 - $4,738 | 86% |
| Humana | $3,738 - $4,643 | 102% |
| Universal Healthcare | $4,250 | 116% |
| Multiplan | $4,658 - $6,899 | 127% |
| Nhc Advantage | $4,950 | 135% |
| Corvel Corporation | $5,531 | 151% |
| Oha Network | $5,764 | 158% |
| Oscar | $5,876 | 161% |
| Cigna | $6,825 - $10,174 | 187% |
Consumer Guidance & Cost Commentary
For the CPT code 49505 (Inguinal hernia repair) at Overland Park Reg Med Ctr in Kansas, the facility's negotiated rates range from $1,121 to $12,237 across 15 different payers, with a median negotiated amount of $4,698. This facility is located in Overland Park (ZIP 66215) and is rated 4 stars. While specific cash or median paid values are not available in the current data, patients should be aware that cash-pay options can sometimes be more cost-effective than insurance negotiated rates, particularly for those with high-deductible plans where the insurer's allowed amount might exceed the cash price. It is crucial to verify the specific "self-pay" or "prompt-pay" discount rates directly with the hospital before scheduling, as these upfront payment incentives can significantly reduce the final bill by bypassing administrative claim processing fees.
The facility's pricing is benchmarked against the Medicare rate of $3,657.95, which serves as an objective baseline for evaluating cost markup. The median negotiated rate of $4,698 represents a 1.3x multiplier compared to the Medicare amount, indicating the typical administrative and contractual overhead included in commercial insurance pricing. Patients should avoid comparing these rates to the hospital's full chargemaster list, as that figure is inflated and not reflective of actual costs. To ensure transparency and avoid unexpected balance billing, consumers are encouraged to request a detailed, itemized bill that breaks down every CPT code and service rendered, allowing for a systematic review to identify any errors, unbundled charges, or services not actually provided.