Inguinal hernia repair
Facility: Morris County Hospital
Billing Code: 49505 (CPT)
- CPT Billing Code: 49505
- Insurance Median: $4,301
- Cash Discount Price: $3,802
- vs. Medicare Baseline: 1.18x 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 |
|---|---|---|
| Providrs Care (Wppa)(Nexus)-All Plans | $1,514 | 41% |
| Va Ccn-All Plans | $2,471 | 68% |
| Coventry Mcr | $2,471 | 68% |
| UnitedHealthcare | $2,471 - $6,336 | 68% |
| Blue Cross Blue Shield | $2,471 - $4,411 | 68% |
| Choice Care Mcr Adv-All Plans | $2,471 | 68% |
| Cigna | $4,583 | 125% |
| Aetna | $5,677 | 155% |
| Coventry Comm-All Other Plans | $5,702 | 156% |
| Multiplan-All Plans | $5,702 | 156% |
Consumer Guidance & Cost Commentary
For the CPT code 49505 (Inguinal hernia repair) at Morris County Hospital in Council Grove, KS, the cash median price is $3,802.00, which is lower than the facility's gross charge of $6,336.00. While the facility is a Critical Access Hospital with government ownership, patients should note that commercial negotiated rates often exceed cash prices due to administrative overhead and contract structures. For instance, UnitedHealthcare's negotiated range spans from $2,471 to $6,336, and Aetna's rate is $5,677, both of which are higher than the cash median. If you have a high-deductible plan, paying the cash price of $3,802.00 upfront may result in significant savings compared to your insurance's allowed amount, provided you can secure a prompt-pay discount or self-pay rate before the claim is submitted.
To maximize your financial protection, it is crucial to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Additionally, be aware of balance billing risks, though the No Surprises Act generally protects patients from out-of-network balance billing for emergency care and non-emergency services at in-network facilities. When reviewing your statement, ensure you are comparing rates against the Medicare benchmark of $3,657.95 rather than the inflated chargemaster list, as commercial rates often average 200% to 300% of this baseline. Finally, do not accept summary bills as final invoices; always demand a detailed line