CMS Price Transparency Data

Inguinal hernia repair

Facility: Mosaic Life Care at St Joseph

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $836
Cash Discount Price: $1,576
vs. Medicare Baseline: 0.23x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at Mosaic Life Care at St Joseph is $836. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,576. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.23x the Medicare baseline. Located in 5325 Faraon Street, Saint Joseph, MO.

Cash / Self-Pay

$1,576

Average discount available for prompt cash payment at this facility.

Insurance Median

$836

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: $1,576 (43%)

Insurance Median: $836 (23%)

Cash: $1,576 (43% of Medicare)

Ins. Median: $836 (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
Aetna	$257 - $3,556	7%
Medicaid / KanCare	$257 - $1,121	7%
UnitedHealthcare	$257 - $3,556	7%
Amerigroup Of Iowa	$385	11%
Iowa Total Care	$385	11%
Molina Of Iowa	$385	11%
Blue Cross Blue Shield	$487 - $3,556	13%
Ambetter / Centene	$925 - $6,757	25%
Centurion	$1,298	35%
Geha Shared Services	$1,505	41%
Multiplan	$1,518	41%
Freedom Select Healthlink	$1,592	44%
Healthlink Open Access	$1,592	44%
Preferred Health Professional	$1,592	44%
Sisco	$1,592	44%
Cigna	$1,632	45%

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 $1,576.
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 Mosaic Life Care at St Joseph 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.