CMS Price Transparency Data

Inguinal hernia repair

Facility: Lakewood Health System

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $954
Cash Discount Price: $1,479
vs. Medicare Baseline: 0.26x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at Lakewood Health System is $954. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,479. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.26x the Medicare baseline. Located in 49725 County Road 83, Staples, MN.

Cash / Self-Pay

$1,479

Average discount available for prompt cash payment at this facility.

Insurance Median

$954

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: $1,479 (40%)

Insurance Median: $954 (26%)

Cash: $1,479 (40% of Medicare)

Ins. Median: $954 (26% 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
Ucare Msho/Special Needs	$322 - $983	9%
UnitedHealthcare	$358 - $2,124	10%
Blue Cross Blue Shield	$465 - $1,756	13%
Humana	$465 - $964	13%
Ucare Mcr Adv	$465 - $983	13%
Medica Msho/Mcr Adv	$491	13%
Ucare Individual/Family - All Other Plans	$744 - $1,098	20%
Medica Choice Care	$840 - $1,164	23%
Medica Choice/Focus/Ifb/Mhps - All Other Plans	$840	23%
Preferred One Hmo	$991 - $2,267	27%
Preferred One Ppo - All Other Plans	$1,050 - $2,267	29%
Health Partners - All Plans	$1,230 - $2,243	34%

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 $1,479.
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 Lakewood Health System 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.