Inguinal hernia repair
Facility: Phillips County Hospital
Billing Code: 49505 (CPT)
- CPT Billing Code: 49505
- Insurance Median: $1,691
- Cash Discount Price: $1,275
- vs. Medicare Baseline: 0.46x 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 |
|---|---|---|
| Blue Cross Blue Shield | $242 - $4,411 | 7% |
| Medicaid / KanCare | $900 - $2,100 | 25% |
| Health Partners-All Plans | $900 - $2,100 | 25% |
| UnitedHealthcare | $900 - $2,100 | 25% |
Consumer Guidance & Cost Commentary
For this Inguinal hernia repair at Phillips County Hospital in Phillipsburg, KS, the cash price is $1,275, which is lower than the facility's negotiated rates of $1,691 paid by major payers like Blue Cross Blue Shield, Medicaid/KanCare, and UnitedHealthcare. While the facility's negotiated rates are higher than the cash price, patients with high-deductible plans may find the cash option more cost-effective if their insurance allowed amount exceeds the cash rate. It is important to note that the facility is a Critical Access Hospital with government-local ownership, and while specific county or state average data was not provided in this report, patients should always verify their specific plan's allowed amount before scheduling to ensure they are not being charged more than necessary.
To avoid unexpected costs, patients should request a prompt-pay discount, which can reduce the bill by 20% to 50% if paid in full upfront, bypassing the administrative overhead of insurance claims processing. If you receive a bill after using insurance, do not accept a summary invoice; instead, request a full itemized audit to identify any errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain mistakes. Additionally, if you are concerned about balance billing, remember that the No Surprises Act protects you from being billed for out-of-network emergency care or non-emergency services at in-network facilities, so you should dispute any surprise charges immediately rather than paying them out of fear of credit damage.