CMS Price Transparency Data
Inguinal hernia repair
Facility: Mercy Hospital Joplin
Billing Code: 49505 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 49505
- Insurance Median: $3,143
- Cash Discount Price: $11,601
- vs. Medicare Baseline: 0.86x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Mercy Hospital Joplin is $3,143. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $11,601. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.86x the Medicare baseline. Located in 100 Mercy Way, Joplin, MO.
Cash / Self-Pay
$11,601
Average discount available for prompt cash payment at this facility.
Insurance Median
$3,143
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: $11,601 (317%)
Insurance Median: $3,143 (86%)
Cash: $11,601 (317% of Medicare)
Ins. Median: $3,143 (86% 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.
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 | $363 - $5,415 | 10% |
| Blue Cross Blue Shield | $477 - $5,209 | 13% |
| Indian Health Service Contracted [320198] | $477 | 13% |
| Benefit Management Contracted [320052] | $1,692 | 46% |
| Health Systems Inc Contracted [320174] | $1,692 | 46% |
| Insurance System Inc Contracted [320465] | $1,692 | 46% |
| Aither Health Contracted [320449] | $2,157 | 59% |
| Auxiant Contracted [320462] | $2,157 | 59% |
| Ebms Contracted [320493] | $2,157 | 59% |
| Edison Health Solutions Contracted [320502] | $2,157 | 59% |
| Healthlink Contracted [320179] | $2,157 | 59% |
| Imagine 360 Contracted [320494] | $2,157 | 59% |
| Mercy Benefit Admin Contracted [320251] | $2,157 - $3,226 | 59% |
| Reflect Health Contracted [320492] | $2,157 | 59% |
| Yuzu Health Contracted [320521] | $2,157 | 59% |
| Multiplan Contracted [320270] | $2,283 | 62% |
| Private Health Care Systems Contracted [320320] | $2,283 | 62% |
| Usable Contracted [320409] | $2,283 | 62% |
| Point C Contracted [320238] | $2,328 - $3,045 | 64% |
| Humana | $3,047 - $3,143 | 83% |
| 90 Degree Benefits Contracted [320436] | $3,080 | 84% |
| Show-Me Health Administrators Contracted [320483] | $3,080 - $3,226 | 84% |
| Aetna | $3,143 | 86% |
| Champva [20065] | $3,143 | 86% |
| Cherokee Nation Health Serv Contracted [320066] | $3,143 | 86% |
| Cigna | $3,143 | 86% |
| Cross Timbers Hospice [20098] | $3,143 | 86% |
| Dept Of Veteran Affairs Contracted [320106] | $3,143 | 86% |
| Elara Caring Aspire Hospice [20433] | $3,143 | 86% |
| Globalhealth Contracted [320145] | $3,143 | 86% |
| Halo Hcr Inc Hospice Contracted [320432] | $3,143 | 86% |
| Halo Hcr Inc Hospice [20432] | $3,143 | 86% |
| Kindful Hospice Contracted [320434] | $3,143 | 86% |
| Kindful Hospice [20434] | $3,143 | 86% |
| Medicare (plans) | $3,143 - $3,303 | 86% |
| Mercy Hospice Okc [20252] | $3,143 | 86% |
| Mercy Mgd Behavioral Health Contracted [320259] | $3,143 | 86% |
| Pace Of The Ozarks Contracted [320518] | $3,143 | 86% |
| Provider Partners Health Plans Contracted [320450] | $3,143 | 86% |
| Qual Choice Contracted [320325] | $3,143 | 86% |
| Tricare | $3,143 | 86% |
| UnitedHealthcare | $3,143 - $4,513 | 86% |
| Centivo Contracted [320505] | $3,204 | 88% |
| Healthscope Contracted [320182] | $4,005 | 109% |
| United Medical Resources Contracted [320454] | $4,052 | 111% |
| Health Choice Contracted [320166] | $5,999 | 164% |
| Providrs Care Network Contracted [320484] | $6,528 | 178% |