Inguinal hernia repair
Facility: Osborne County Memorial Hospital
Billing Code: 49505 (CPT)
- CPT Billing Code: 49505
- Insurance Median: $2,094
- Cash Discount Price: $2,326
- vs. Medicare Baseline: 0.57x 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 | $98 - $4,061 | 3% |
| Health Partners Of Kansas | $111 - $4,595 | 3% |
| Wppa | $123 - $5,076 | 3% |
| Blue Cross Blue Shield | $126 - $5,236 | 3% |
Consumer Guidance & Cost Commentary
For an inguinal hernia repair at Osborne County Memorial Hospital in Osborne, KS, the cash price is $2,326, which is lower than the facility's gross charge of $2,736. While the hospital is a Critical Access Hospital owned by the local government, the data does not provide specific county or state average rates for comparison. It is important to note that commercial insurance negotiated rates for this service range from $98 to $5,236 across four payers, meaning the cash price could be significantly lower than what an in-network plan would allow. Patients with high-deductible plans should consider paying the cash price upfront, as this avoids the administrative costs and potential markups associated with insurance billing cycles. Additionally, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as paying in full within a short window can often reduce the final bill further.
The Medicare benchmark for this procedure is $3,657.95, which serves as a reliable baseline for evaluating pricing fairness since it reflects the true cost of care rather than inflated list prices. The facility's cash rate of $2,326 is approximately 63% of the Medicare amount, indicating a pricing structure that is well below the federal standard. If a patient's insurance allows a negotiated rate higher than the cash price, they may face balance billing if they are out-of-network, though the No Surprises Act protects against such surprise bills for emergency care and non-emergency services at in-network facilities. To ensure accuracy, patients should request a full itemized bill before paying, as summary invoices can obscure unbundled charges or services not rendered. Disputing