Inguinal hernia repair
Facility: Nemaha Valley Community Hospital
Billing Code: 49505 (CPT)
- CPT Billing Code: 49505
- Insurance Median: $491
- Cash Discount Price: $1,431
- vs. Medicare Baseline: 0.13x 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 |
|---|---|---|
| Midlands Choice - All Plans | $68 | 2% |
| Humana | $457 | 12% |
| Va Ccn - All Plans | $457 | 12% |
| Aetna | $461 - $625 | 13% |
| Celtic Comm Exch - All Plans | $480 | 13% |
| Partners Direct Health - All Plans | $502 | 14% |
| Health Partners - All Plans | $727 | 20% |
| Blue Cross Blue Shield | $761 | 21% |
| Multiplan - All Plans | $954 | 26% |
Consumer Guidance & Cost Commentary
For the Inguinal hernia repair procedure (CPT 49505) at Nemaha Valley Community Hospital in Seneca, KS, the cash median price is $1,431, while the median negotiated rate across nine payers is $954. This facility, a Critical Access Hospital, does not have a state or county average provided for comparison in this dataset. It is important to note that while cash payments can sometimes be cheaper for patients with high-deductible plans, the negotiated rate here ($954) is actually lower than the cash price ($1,431). Patients should verify their specific plan's deductible status and allowed amounts before scheduling, as paying out-of-pocket may result in a higher out-of-pocket cost compared to using insurance coverage.
When reviewing your final bill, ensure you receive a detailed, itemized statement rather than a summary bill, as over 80% of hospital bills contain errors such as double-billing or unbundled codes. If you receive a balance bill for services rendered at an in-network facility, you may be protected under the No Surprises Act, which bans balance billing for emergency care and non-emergency services from out-of-network providers. Additionally, if you are paying directly, ask about prompt-pay discounts, which can reduce the total cost by 20% to 50% if settled upfront, bypassing the administrative costs associated with insurance claims processing. Always dispute any unexpected charges in writing to ensure accuracy and protect your financial interests.