Inguinal hernia repair
Facility: Menorah Medical Center
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 - $9,451 | 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 Menorah Medical Center in Overland Park, KS, 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 Johnson County, Kansas, and its pricing structure is significantly higher than the national average, as indicated by a ratio of 1.3 times the Medicare benchmark rate. While the facility's median negotiated rate of $4,698 is notably higher than the Medicare amount of $3,657.95, patients should be aware that cash-pay options may offer a lower out-of-pocket cost if their insurance negotiated rate exceeds the cash price. It is important to verify the specific allowed amount for your plan before scheduling, as in-network rates can vary widely by carrier, with some plans paying as low as $1,121 and others reaching up to $12,237 for this procedure.
Patients should proactively inquire about self-pay or prompt-pay discounts before check-in, as hospitals often offer fee reductions of 20% to 50% for upfront payments that bypass costly insurance billing cycles and administrative overhead. Since over 80% of hospital bills contain errors, consumers are encouraged to request a detailed, itemized bill to identify any unbundled codes or services not rendered, rather than accepting a summary invoice. Additionally, while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, it is crucial to ensure that any consent forms signed do not inadvertently waive these