CMS Price Transparency Data

Inguinal hernia repair

Facility: Perham Health

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $609
Cash Discount Price: $1,100
vs. Medicare Baseline: 0.17x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at Perham Health is $609. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,100. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.17x the Medicare baseline. Located in 1000 Coney Street West, Perham, MN.

Cash / Self-Pay

$1,100

Average discount available for prompt cash payment at this facility.

Insurance Median

$609

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: $1,100 (30%)

Insurance Median: $609 (17%)

Cash: $1,100 (30% of Medicare)

Ins. Median: $609 (17% 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 Mn Special Needs Basic Care Dual	$322 - $604	9%
Ucare Mn Medical Assistance	$354 - $609	10%
Ucare Mn Minnesota Care	$354 - $609	10%
Ucare Mn Senior Care Plus	$354 - $609	10%
Ucare Mn Special Needs Basic Care	$354 - $609	10%
Blue Cross Blue Shield	$465 - $1,145	13%
Health Partners Mcr Adv	$465 - $576	13%
Humana	$465 - $576	13%
Medicare (plans)	$465 - $677	13%
Ucare Individual And Family Plan-All Other Plans	$515 - $846	14%
Medica Mcr Adv	$535 - $576	15%
Ucare Mn Senior Health Options	$576 - $846	16%
UnitedHealthcare	$591 - $1,693	16%
Medicaid / KanCare	$610 - $1,744	17%
Medica Mcaid Mn Care	$620	17%
Medica Mn (Msho)	$698	19%
Health Partners Minnesota Care	$846	23%
Medica Mn Senior Hp/Outside Mn	$863	24%
Preferred One (Pchp, Pic, Pas)-All Other Plans	$931 - $1,270	25%
Sanford Health Plan-All Plans	$961 - $1,439	26%
Medica Commercial-All Other Plans	$1,239	34%
Health Partners-All Plans	$1,388	38%
Preferred One (Ppo)	$1,439	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 $1,100.
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 Perham 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.