Inguinal hernia repair
Facility: University Of Ks Hlth System Great Bend Campus
Billing Code: 49505 (CPT)
- CPT Billing Code: 49505
- Insurance Median: $4,629
- Cash Discount Price: $3,905
- vs. Medicare Baseline: 1.27x 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 |
|---|---|---|
| UnitedHealthcare | $1,121 - $3,343 | 31% |
| Blue Cross Blue Shield | $1,121 - $4,411 | 31% |
| Medicaid / KanCare | $1,121 | 31% |
| Ku Athletics [503200094] | $3,343 | 91% |
| Workers Comp [503999901] | $3,343 - $5,822 | 91% |
| Medicare (plans) | $3,410 | 93% |
| Allwell [503200078] | $3,443 | 94% |
| Humana | $3,527 | 96% |
| Triwest [503201703] | $3,527 | 96% |
| Tricare | $3,527 | 96% |
| Centurion [5032000966] | $4,346 | 119% |
| Ambetter / Centene | $4,847 | 133% |
| Prime Health Services [503999912] | $5,822 | 159% |
| Alt Bnsf Railway Co [503301503] | $5,822 | 159% |
| Sedgwick Claims Management Services [53201618] | $5,822 | 159% |
| Gallagher Bassett [5032000103] | $5,822 | 159% |
| Fort Hays State Student Athletes [5032000960] | $7,020 | 192% |
| Occunet [503999930] | $7,020 | 192% |
| 6 Degrees Health [503999050] | $8,357 | 228% |
| Advanced Medical Pricing Solutions [503301513] | $10,580 | 289% |
Consumer Guidance & Cost Commentary
For the inguinal hernia repair procedure (CPT 49505) at the University of KS Health System Great Bend Campus, the cash median price is $3,905.00, which is significantly lower than the facility's negotiated rates with major payers like UnitedHealthcare and Blue Cross Blue Shield. While the facility's cash price is competitive, it is important to note that commercial insurance contracts often result in higher allowed amounts due to administrative overhead and contract dynamics; for instance, the median negotiated rate across payers is $4,629.00. Patients with high-deductible plans may find that paying the cash price upfront is more cost-effective than relying on insurance, as the insurer's allowed amount could exceed the cash rate, potentially leading to higher out-of-pocket costs if the deductible is not yet met.
The facility's pricing is benchmarked against Medicare, which serves as a scientifically validated baseline for healthcare costs. The Medicare amount for this service is $3,657.95, and the facility's cash price of $3,905.00 represents a 1.3x markup relative to this federal rate, aligning closely with fair pricing standards that typically range between 120% and 150% of Medicare. To ensure you are receiving the best possible rate, we recommend requesting an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Additionally, since the facility is a government-owned hospital district, you should explicitly ask about self-pay or prompt-pay discounts, which can reduce the total bill by 20% to