Inguinal hernia repair
Facility: Mitchell County Hospital Health Systems
Billing Code: 49505 (CPT)
- CPT Billing Code: 49505
- Insurance Median: $666
- Cash Discount Price: $799
- vs. Medicare Baseline: 0.18x 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 | $377 - $983 | 10% |
| First Health-All Plans | $626 - $876 | 17% |
| Aetna | $626 - $876 | 17% |
| Triwest Well Mark All Plans | $629 - $880 | 17% |
Consumer Guidance & Cost Commentary
For the Inguinal hernia repair procedure (CPT 49505) at Mitchell County Hospital Health Systems in Beloit, KS, the facility's cash median rate of $799.00 is notably lower than the average commercial negotiated rates paid by major payers, which range from $626 to $983 depending on the insurer. While the facility is a Critical Access Hospital with government-local ownership, patients should be aware that commercial insurance contracts often result in higher allowed amounts than self-pay options. Specifically, the cash price of $799.00 is lower than the median negotiated rate of $666.00 reported for this service, meaning individuals with high-deductible plans or those paying out-of-pocket may save money by selecting the cash-pay option, provided they qualify for the facility's self-pay or prompt-pay discounts.
To ensure you are not overcharged, it is critical to request a full itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered. If you receive a balance bill from an out-of-network provider at this in-network facility, you may be protected under the No Surprises Act, which bans balance billing for emergency and non-emergency services; in such cases, you should dispute the bill in writing rather than paying immediately to avoid unexpected costs. Furthermore, your commercial payment of $629.00 (median paid) is significantly lower than the Medicare benchmark of $3,657.95, indicating that the facility's pricing aligns with fair market value standards rather than the inflated chargemaster list price.