CMS Price Transparency Data

Inguinal hernia repair

Facility: McLaren Flint

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $1,930
Cash Discount Price: $4,179
vs. Medicare Baseline: 0.53x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at McLaren Flint is $1,930. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,179. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.53x the Medicare baseline. Located in 401 S Ballenger Highway, Flint, MI.

Cash / Self-Pay

$4,179

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,930

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$3,657.95

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $3,657.95 (100%)

Cash / Self-Pay: $4,179 (114%)

Insurance Median: $1,930 (53%)

Cash: $4,179 (114% of Medicare)

Ins. Median: $1,930 (53% of 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Medicaid / KanCare	$340 - $1,988	9%
Humana	$501 - $3,442	14%
Medicare (plans)	$501 - $5,507	14%
Mclaren Commercial Ins	$531	15%
U Of M Health Plan	$576	16%
Aetna	$676	18%
UnitedHealthcare	$781	21%
Priority Health	$802	22%
Blue Cross Blue Shield	$849 - $4,704	23%
Tricare	$3,365	92%
Mi Amish Medical Board	$3,442	94%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $4,179.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 49505.

Insurance In-Network Protection Plan

Contact your insurance company to confirm McLaren Flint is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 49505.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.