CMS Price Transparency Data

Inguinal hernia repair

Facility: Barnes Jewish Hospital

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $8,138
Cash Discount Price: $20,803
vs. Medicare Baseline: 2.22x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at Barnes Jewish Hospital is $8,138. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $20,803. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 2.22x the Medicare baseline. Located in One Barnes-Jewish Hospital Plaza, Saint Louis, MO.

Cash / Self-Pay

$20,803

Average discount available for prompt cash payment at this facility.

Insurance Median

$8,138

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: $20,803 (569%)

Insurance Median: $8,138 (222%)

Cash: $20,803 (569% of Medicare)

Ins. Median: $8,138 (222% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 222% of the Medicare baseline (a markup of 122%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Consociate [478]	$5,018	137%
Sarah Bush Lincoln [636]	$5,018	137%
Aetna	$6,081 - $15,154	166%
Blue Cross Blue Shield	$6,081 - $10,311	166%
Essence Healthcare [221]	$6,081	166%
Humana	$6,081 - $8,188	166%
UnitedHealthcare	$6,081 - $9,946	166%
Cox Health [757]	$6,385	175%
Devoted Health Plan [847]	$6,385	175%
Medica [662]	$6,385	175%
Cigna	$7,184 - $11,562	196%
Healthscope Benefits [258]	$9,946	272%
Apwu Health Plan [216]	$11,562	316%
Nalc Health Benefit Plan [242]	$11,562	316%
Priority Health [648]	$11,562	316%
Allied Benefits [498]	$15,154	414%
Coresource [497]	$15,154	414%
Fmh Benefit Service Inc [222]	$15,154	414%
Mail Handlers [495]	$15,154	414%

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 $20,803.
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 Barnes Jewish Hospital 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.