Inguinal hernia repair
Facility: Hodgeman County Health Center
Billing Code: 49505 (CPT)
- CPT Billing Code: 49505
- Insurance Median: $4,235
- Cash Discount Price: $5,294
- vs. Medicare Baseline: 1.16x 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 |
|---|---|---|
| Aetna | $3,200 | 87% |
| Blue Cross Blue Shield | $3,621 - $3,812 | 99% |
| UnitedHealthcare | $4,235 - $6,286 | 116% |
| Humana | $4,235 | 116% |
| Triwest - All Plans | $4,235 | 116% |
| Medicaid / KanCare | $4,235 - $6,617 | 116% |
| First Health - All Plans | $5,955 | 163% |
| Wppa (Provdrscare) - All Plans | $6,286 | 172% |
| Health Partners - All Plans | $6,286 | 172% |
Consumer Guidance & Cost Commentary
For an inguinal hernia repair at Hodgeman County Health Center in Jetmore, Kansas, the facility's cash price of $5,294 is lower than the average negotiated rates paid by major insurers like UnitedHealthcare ($4,235 to $6,286) and Medicaid/KanCare ($4,235 to $6,617). While the facility's cash rate is also below the gross charge of $6,617, it remains higher than the median negotiated rate of $4,235 reported across the state. Because commercial insurance contracts often include administrative overheads that inflate the baseline price by 20% to 40%, patients with high-deductible plans may find paying the cash price directly more affordable than relying on insurance, which could result in a higher allowed amount. It is important to note that while the facility is a Critical Access Hospital with government ownership, patients should verify their specific plan's deductible status before scheduling, as meeting the deductible is required before the insurer will cover any portion of the cost.
Patients should be aware that the reported data reflects the facility's standard billing practices, but individual bills may vary based on specific services rendered and local pricing adjustments. If you receive a bill, always request a full itemized statement to review every CPT code and unit cost, as over 80% of hospital bills contain errors such as double-billing or unbundled charges that can be disputed. Additionally, if you are uninsured or have limited coverage, ask the billing department about "prompt-pay" discounts, which can reduce the total cost by 20% to 50% if paid in full upfront. Finally, if you