Inguinal hernia repair
Facility: Logan County Hospital
Billing Code: 49505 (CPT)
- CPT Billing Code: 49505
- Insurance Median: $4,094
- Cash Discount Price: $2,895
- vs. Medicare Baseline: 1.12x 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 |
|---|---|---|
| Medicaid / KanCare | $411 - $9,650 | 11% |
| Humana | $461 - $4,094 | 13% |
| UnitedHealthcare | $461 | 13% |
| Blue Cross Blue Shield | $4,120 | 113% |
| Health Partners - All Plans | $9,167 | 251% |
Consumer Guidance & Cost Commentary
For the Inguinal hernia repair procedure (CPT 49505) at Logan County Hospital in Oakley, KS, the cash median price is $2,895, which is lower than the facility's gross charge of $5,575. While the hospital is a Critical Access Hospital with government local ownership, patients should note that commercial insurance negotiated rates often exceed cash prices due to administrative costs and contract structures. For instance, the median negotiated rate across payers is $4,094, and the highest allowed amount from Health Partners is $9,167. If you have a high-deductible plan, paying the cash price upfront could save you money compared to your insurance's allowed amount, provided you have not yet met your deductible. It is always advisable to ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these can further reduce the final cost.
When evaluating this rate against benchmarks, the Medicare amount for this service is $3,657.95, and the facility's cash price is approximately 79% of the Medicare rate. This suggests the facility is pricing below the federal cost baseline, which is common for Critical Access Hospitals operating under specific federal reimbursement rules. However, commercial payers like Medicaid/KanCare and Humana have negotiated rates ranging from $411 to $9,650, indicating significant variation based on plan type and network status. Because the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, you can expect the hospital to adhere to the negotiated rates listed above rather than charging the full chargemaster. Always request an itemized