CMS Price Transparency Data

Inguinal hernia repair

Facility: M Health Fairview Ridges Hospital

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $1,585
Cash Discount Price: $861
vs. Medicare Baseline: 0.43x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at M Health Fairview Ridges Hospital is $1,585. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $861. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.43x the Medicare baseline. Located in 201 East Nicollet Boulevard, Burnsville, MN.

Cash / Self-Pay

$861

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,585

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: $861 (24%)

Insurance Median: $1,585 (43%)

Cash: $861 (24% of Medicare)

Ins. Median: $1,585 (43% 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
Sanford Health Plan	$297 - $3,433	8%
Health Partners	$345 - $7,942	9%
Itasca Medical Care	$345 - $3,433	9%
Primewest	$345 - $3,433	9%
South Country Health Alliance	$345 - $3,433	9%
Ucare	$352 - $7,889	10%
Medica	$367 - $4,192	10%
Security Health Plan	$368 - $3,433	10%
America'S Ppo	$383 - $2,002	10%
Hennepin Health	$390 - $3,554	11%
Blue Cross Blue Shield	$393 - $6,349	11%
First Health	$413 - $2,078	11%
Multiplan	$428 - $2,154	12%
Private Healthcare Systems	$428 - $2,154	12%
Wisconsin Physician Services	$454 - $2,280	12%
UnitedHealthcare	$468 - $5,499	13%
Wellcare	$468 - $3,433	13%

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 $861.
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 M Health Fairview Ridges Hospital 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.