CMS Price Transparency Data

Inguinal hernia repair

Facility: Mercy Hospital St Louis

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $3,279
  • Cash Discount Price: $6,840
  • vs. Medicare Baseline: 0.90x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Mercy Hospital St Louis is $3,279. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,840. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.90x the Medicare baseline. Located in 615 New Ballas Road, Saint Louis, MO.
Cash / Self-Pay
$6,840

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,279

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: $6,840 (187%)
Insurance Median: $3,279 (90%)
Cash: $6,840 (187% of Medicare)
Ins. Median: $3,279 (90% 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
Blue Cross Blue Shield $496 - $7,801 14%
Indian Health Service Contracted [320198] $496 14%
Mercy Benefit Admin Contracted [320251] $1,400 - $3,234 38%
Mercy Benefit Admin [20251] $1,400 - $3,234 38%
Medicaid / KanCare $3,008 - $4,693 82%
Show-Me Health Administrators Contracted [320483] $3,140 - $3,297 86%
Aither Health Contracted [320449] $3,234 88%
Aither Health [20449] $3,234 88%
Auxiant Contracted [320462] $3,234 88%
Ebms Contracted [320493] $3,234 88%
Edison Health Solutions Contracted [320502] $3,234 88%
Healthlink Contracted [320179] $3,234 88%
Imagine 360 Contracted [320494] $3,234 88%
Reflect Health Contracted [320492] $3,234 88%
Yuzu Health Contracted [320521] $3,234 88%
Aetna $3,279 90%
American Health Advantage Of Mo Mcr [10473] $3,279 90%
Cherokee Nation Health Serv Contracted [320066] $3,279 90%
Cross Timbers Hospice [20098] $3,279 90%
Dept Of Veteran Affairs Contracted [320106] $3,279 90%
Elara Caring Aspire Hospice Contracted [320433] $3,279 90%
Elara Caring Aspire Hospice [20433] $3,279 90%
Globalhealth Contracted [320145] $3,279 90%
Halo Hcr Inc Hospice Contracted [320432] $3,279 90%
Halo Hcr Inc Hospice [20432] $3,279 90%
Humana $3,279 90%
Kindful Hospice Contracted [320434] $3,279 90%
Kindful Hospice [20434] $3,279 90%
Medicare (plans) $3,279 - $3,410 90%
Mercy Hospice Okc [20252] $3,279 90%
Pace Of The Ozarks Contracted [320518] $3,279 90%
Qual Choice Contracted [320325] $3,279 90%
Tricare $3,279 90%
UnitedHealthcare $3,279 - $3,911 90%
Hope Trust Contracted [320488] $3,343 91%
Cigna $3,345 91%
Medica Contracted [320239] $3,530 97%
Provider Partners Health Plans Contracted [320450] $3,613 99%
Healthscope Contracted [320182] $4,178 114%
Centivo Contracted [320505] $5,516 151%
Preferred Health Plan Contracted [320522] $5,850 160%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 615 New Ballas Road, Saint Louis, MO 63141
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals