Inguinal hernia repair
Facility: Cheyenne County Hospital
Billing Code: 49505 (CPT)
- CPT Billing Code: 49505
- Insurance Median: $4,028
- Cash Discount Price: $2,877
- vs. Medicare Baseline: 1.10x 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 |
|---|---|---|
| Healthy Blue Mcr Adv | $289 - $4,405 | 8% |
| Tricare | $289 - $4,405 | 8% |
| Aetna | $289 - $5,812 | 8% |
| UnitedHealthcare | $289 - $6,118 | 8% |
| Choice Care - All Plans | $319 - $4,449 | 9% |
| First Health - All Plans | $455 - $4,282 | 12% |
| Firstguard - All Plans | $520 - $4,894 | 14% |
| Wppa - All Plans | $585 - $5,506 | 16% |
| Cpm - All Plans | $618 - $5,812 | 17% |
| Preferred Hc - All Plans | $618 - $5,812 | 17% |
| Midlands Choice - All Plans | $631 - $5,934 | 17% |
| Health Partners - All Plans | $637 - $5,995 | 17% |
| Integrated Hp - All Plans | $637 - $5,995 | 17% |
| Unicare - All Plans | $637 - $5,995 | 17% |
| Ppo Next - All Plans | $637 - $5,995 | 17% |
| Childrens Mercy - All Plans | $650 - $6,118 | 18% |
| Healthy Blue Mcaid - All Other Plans | $650 - $6,118 | 18% |
| Healthwave Mcaid - All Plans | $650 - $6,118 | 18% |
| Providers Care-All Plans | $976 - $9,177 | 27% |
| Blue Cross Blue Shield | $3,774 | 103% |
Consumer Guidance & Cost Commentary
For the inguinal hernia repair procedure (CPT 49505) at Cheyenne County Hospital, the facility's cash price of $2,877 is lower than the median negotiated rate of $4,405 paid by most payers, including Healthy Blue McR Adv and Tricare. While the gross chargemaster is $3,384, commercial insurance contracts often result in higher allowed amounts due to administrative overhead and network tiering. Patients with high-deductible plans may find it financially advantageous to pay the cash price directly, as the $2,877 rate is significantly below the typical negotiated ceiling of $4,405 to $6,118 seen across major carriers like Aetna and UnitedHealthcare. It is important to note that the facility's cash rate is also lower than the Medicare benchmark of $3,657.95, suggesting that paying out-of-pocket could result in substantial savings compared to standard insurance billing structures.
To maximize savings, patients should proactively request "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can further reduce the final bill by bypassing costly insurance claims processing. Although the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, it is crucial to verify that all ancillary services, such as lab work or anesthesia, are also covered under the facility's negotiated rates to avoid unexpected charges. Consumers should also be aware that while the facility is a voluntary non-profit Critical Access Hospital in St. Francis, KS, the specific negotiated rates vary widely by payer, with some plans like Providers Care-All Plans having a high-end