Inguinal hernia repair
Facility: Bob Wilson Memorial Hospital
Billing Code: 49505 (CPT)
- CPT Billing Code: 49505
- Insurance Median: $5,500
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.50x 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 |
|---|---|---|
| Blue Cross Blue Shield | $5,500 | 150% |
Consumer Guidance & Cost Commentary
For the Inguinal hernia repair procedure at Bob Wilson Memorial Hospital in Ulysses, KS, the facility's negotiated rate of $5,500 is significantly higher than the Medicare benchmark of $3,657.95, representing a 1.5x markup. This facility, a voluntary non-profit Critical Access Hospital, has a single payer in its network, Blue Cross Blue Shield, which also sets the negotiated rate at $5,500. While commercial insurance contracts often include administrative overhead that inflates prices by 20% to 40% above the true cost of care, patients with high-deductible plans may find that paying the cash price directly could be more affordable if the facility offers a self-pay discount. It is important to verify the facility's specific cash rate before scheduling, as commercial negotiated rates are frequently higher than the cash price due to the multi-layered billing structures required for insurance claims.
To ensure you receive the best possible price, you should proactively ask the hospital about "prompt-pay" discounts, which can reduce bills by 20% to 50% for upfront payment. Since hospitals save on administrative costs when patients pay in full, these discounts are often available but require you to request self-pay classification and a waiver of insurance submission before check-in to avoid automatic claims processing. Additionally, because over 80% of hospital bills contain errors, you should request a detailed, itemized statement rather than accepting a summary bill, which may hide unbundled charges or services not rendered. By comparing the facility's rates directly to the Medicare benchmark and actively seeking out cash or prompt-pay options, you can avoid unexpected costs and ensure you are paying a