Inguinal hernia repair
Facility: Scott County Hospital
Billing Code: 49505 (CPT)
- CPT Billing Code: 49505
- Insurance Median: $4,120
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.13x 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 | $1,121 - $5,828 | 31% |
| Wppa | $1,200 - $3,681 | 33% |
| Humana | $2,577 | 70% |
| Blue Cross Blue Shield | $4,120 | 113% |
| Aetna | $5,522 | 151% |
Consumer Guidance & Cost Commentary
For an inguinal hernia repair at Scott County Hospital in Scott City, KS, the negotiated rates range from $1,121 to $5,522 depending on your specific insurance plan, with UnitedHealthcare offering the lowest contract rate of $1,121 and Aetna the highest at $5,522. While the facility's cash price is not listed, it is important to note that commercial negotiated rates often exceed cash prices due to administrative costs and contract structures; therefore, patients with high-deductible plans may find paying out-of-pocket or utilizing a "prompt-pay" discount more cost-effective than relying on insurance. To secure the best possible rate, you should verify your specific plan's allowed amount before scheduling and explicitly ask the hospital about self-pay or prompt-pay discounts, which can reduce bills by 20% to 50% when paid upfront.
The facility's negotiated rate of $4,120 is significantly higher than the Medicare benchmark of $3,657.95, reflecting a markup common in commercial healthcare pricing where rates often average 200% to 300% of the Medicare amount. Although the data does not provide specific county or state average comparisons for this procedure, the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, ensuring that the final bill aligns with the negotiated rate rather than the hospital's full chargemaster. If you receive an itemized bill, review it carefully for unbundled codes or services not rendered, as over 80% of hospital bills contain errors that can be corrected through a formal written audit dispute.