Inguinal hernia repair
Facility: Fredonia Regional Hospital
Billing Code: 49505 (CPT)
- CPT Billing Code: 49505
- Insurance Median: $4,120
- Cash Discount Price: $5,124
- 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 | $2,122 - $4,612 | 58% |
| Blue Cross Blue Shield | $2,535 - $4,120 | 69% |
| Veterans Programs - All Plans | $2,613 | 71% |
| Aetna | $2,613 - $4,612 | 71% |
| Meritain-All Plans | $4,612 | 126% |
| Reserve National-All Plans | $4,612 | 126% |
| Cigna | $4,612 | 126% |
Consumer Guidance & Cost Commentary
For the inguinal hernia repair procedure at Fredonia Regional Hospital in Fredonia, Kansas, the cash median price is $5,124.00, which matches the facility's negotiated rate. This cash price is significantly higher than the state average for this service, as indicated by a ratio of 1.1 times the Medicare benchmark amount of $3,657.95. While commercial insurance plans like UnitedHealthcare and Aetna negotiate rates ranging from $2,122 to $4,612 depending on the specific plan, these negotiated amounts often exceed the cash price for patients with high-deductible plans. In such cases, paying the cash median directly can result in lower out-of-pocket costs compared to the insurance negotiated rate, provided the patient has not yet met their deductible.
Patients should verify if the facility offers self-pay or prompt-pay discounts before scheduling, as these upfront payment incentives can reduce the total bill by 20% to 50%. It is important to avoid accepting summary bills that only show broad categories like "Laboratory" or "Pharmacy," as these often obscure individual code costs and may include unbundled charges for components like sutures or scalpel blades that should be bundled. To ensure accuracy, consumers should request a full itemized CPT-coded bill to identify any services not rendered or double-billing errors, and dispute any discrepancies in writing rather than relying on verbal assurances from customer service.