Inguinal hernia repair
Facility: Minneola District Hospital
Billing Code: 49505 (CPT)
- CPT Billing Code: 49505
- Insurance Median: $3,424
- Cash Discount Price: $2,055
- vs. Medicare Baseline: 0.94x 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 |
|---|---|---|
| Humana | $391 - $3,424 | 11% |
| UnitedHealthcare | $391 - $5,110 | 11% |
| Va Community Care Program-All Plans | $391 - $3,424 | 11% |
| Corporate Plan Management-All Plans | $646 - $4,344 | 18% |
| Providrs Care Network-All Plans | $646 - $4,344 | 18% |
| Preferred Health Care (Coventry)-All Other Plans | $684 - $4,599 | 19% |
| Triwest-All Plans | $684 - $4,599 | 19% |
| Health Partners Of Kansas-All Plans | $722 - $4,854 | 20% |
| Aetna | $722 - $5,110 | 20% |
| Phc (Coventry) Leased Network | $722 - $4,854 | 20% |
| Medicaid / KanCare | $760 - $5,110 | 21% |
| Blue Cross Blue Shield | $3,812 | 104% |
Consumer Guidance & Cost Commentary
For an inguinal hernia repair at Minneola District Hospital, the cash price is $2,055, which is lower than the facility's negotiated rate of $3,424. This cash rate is also 55% lower than the Medicare benchmark of $3,657.95, indicating a significant discount from the federal baseline. While commercial payers like Humana and UnitedHealthcare negotiate rates ranging from $391 to over $5,000 depending on the plan, patients with high-deductible plans may find paying cash directly more cost-effective than relying on insurance, as the negotiated allowed amounts often exceed the cash price. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still verify their specific plan details and ask the hospital about self-pay or prompt-pay discounts before scheduling to ensure they receive the lowest possible rate.
The facility, a Critical Access Hospital in Minneola, KS, operates under a government ownership model, which may influence its pricing structure compared to private entities. Although the data provided does not include specific county or state average figures for this procedure, the facility's cash rate of $2,055 serves as a strong reference point for consumers to evaluate potential savings. Patients should be cautious of summary bills that obscure individual charges and should always request a full itemized statement to identify any unbundled codes or services not rendered. If a patient receives a bill that appears higher than expected, they should dispute it in writing with the billing supervisor rather than accepting the summary invoice, as over 80% of hospital bills contain errors that can be corrected through a