CMS Price Transparency Data

Inguinal hernia repair

Facility: Astera Health

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $849
Cash Discount Price: $1,130
vs. Medicare Baseline: 0.23x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at Astera Health is $849. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,130. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.23x the Medicare baseline. Located in 421 11Th Street Nw, Wadena, MN.

Cash / Self-Pay

$1,130

Average discount available for prompt cash payment at this facility.

Insurance Median

$849

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: $1,130 (31%)

Insurance Median: $849 (23%)

Cash: $1,130 (31% of Medicare)

Ins. Median: $849 (23% 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
Blue Plus Pmap [40002]	$305 - $475	8%
Ucare Pmap [30006]	$355 - $6,648	10%
Health Partners Pmap [10046]	$367 - $9,186	10%
Medica Pmap [10057]	$367 - $6,812	10%
Primewest Pmap [30003]	$367 - $6,812	10%
Blue Cross Blue Shield	$475 - $13,889	13%
Health Partners [10045]	$475 - $13,058	13%
Medica Nonpmap [10056]	$475 - $121,916	13%
Primewest Non Pmap [30004]	$475	13%
Ucare Non Pmap [30007]	$475 - $7,670	13%
Sanford Health Plan [10120]	$584 - $792	16%
UnitedHealthcare	$648 - $14,117	18%
Ucare Commercial [10705]	$1,163 - $13,577	32%
Multiplan	$1,252 - $14,610	34%
Aetna	$1,409 - $16,437	39%

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 $1,130.
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 Astera Health 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.