Inguinal hernia repair
Facility: Neosho Memorial Regional Medical Center
Billing Code: 49505 (CPT)
- CPT Billing Code: 49505
- Insurance Median: $1,121
- Cash Discount Price: $1,082
- vs. Medicare Baseline: 0.31x 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 |
|---|---|---|
| Tricare | $444 | 12% |
| Humana | $512 | 14% |
| Medadv_Allwell | $512 | 14% |
| Va_Ccn | $512 | 14% |
| Aetna | $512 | 14% |
| Medadv_Uhc | $512 | 14% |
| Medicare (plans) | $512 | 14% |
| Blue Cross Blue Shield | $512 - $1,442 | 14% |
| Ambetter / Centene | $537 | 15% |
| Medicaid / KanCare | $1,121 | 31% |
| Wppa_Providrscare | $1,197 | 33% |
| United | $1,200 | 33% |
| Cigna | $1,370 | 37% |
| Hpk | $1,370 | 37% |
| Coventry | $1,370 | 37% |
Consumer Guidance & Cost Commentary
For this inguinal hernia repair at Neosho Memorial Regional Medical Center in Chanute, KS, the facility's cash price of $1,082 is lower than the gross charge of $1,442 but higher than the median negotiated rate of $1,121 paid by most insurers. While the facility is a Critical Access Hospital with government local ownership, patients should be aware that commercial insurance plans often pay significantly more than the cash price due to administrative overhead and contract structures. For instance, Blue Cross Blue Shield has two plans paying up to $1,442, while Medicaid/KanCare plans pay $1,121, which aligns with the median negotiated amount. If you have a high-deductible plan, paying the cash price directly might save you money compared to your insurance's negotiated rate, provided you can afford the upfront cost.
To avoid unexpected costs, patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these can reduce the final bill by 20% to 50%. Additionally, if you receive a bill from an out-of-network provider at this in-network facility, the No Surprises Act may protect you from balance billing for emergency care or non-emergency services from out-of-network physicians. If you do receive a surprise bill, do not pay it immediately; instead, request a formal itemized audit to identify errors such as unbundled codes or services not rendered, and dispute the charges in writing with the billing supervisor. Always verify your deductible status before using insurance, as paying the full negotiated rate without meeting your deductible can result in higher out-of-pocket expenses than paying cash outright.