CMS Price Transparency Data

Inguinal hernia repair

Facility: Mercy Hospital Washington

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $3,767
  • Cash Discount Price: $5,989
  • vs. Medicare Baseline: 1.03x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Mercy Hospital Washington is $3,767. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,989. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 1.03x the Medicare baseline. Located in 901 East 5Th Street, Washington, MO.
Cash / Self-Pay
$5,989

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,767

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: $5,989 (164%)
Insurance Median: $3,767 (103%)
Cash: $5,989 (164% of Medicare)
Ins. Median: $3,767 (103% 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 $477 - $12,455 13%
Indian Health Service Contracted [320198] $477 13%
Mercy Benefit Admin Contracted [320251] $1,400 - $2,975 38%
Mercy Benefit Admin [20251] $1,400 - $2,975 38%
Show-Me Health Administrators Contracted [320483] $2,889 - $3,033 79%
Aither Health Contracted [320449] $2,975 81%
Aither Health [20449] $2,975 81%
Auxiant Contracted [320462] $2,975 81%
Ebms Contracted [320493] $2,975 81%
Edison Health Solutions Contracted [320502] $2,975 81%
Healthlink Contracted [320179] $2,975 81%
Imagine 360 Contracted [320494] $2,975 81%
Reflect Health Contracted [320492] $2,975 81%
Yuzu Health Contracted [320521] $2,975 81%
Medicaid / KanCare $3,008 - $4,964 82%
Medica Contracted [320239] $3,530 97%
UnitedHealthcare $3,911 - $5,531 107%
Aetna $5,531 - $8,654 151%
American Health Advantage Of Mo Mcr [10473] $5,531 151%
Cherokee Nation Health Serv Contracted [320066] $5,531 151%
Cross Timbers Hospice [20098] $5,531 151%
Dept Of Veteran Affairs Contracted [320106] $5,531 151%
Elara Caring Aspire Hospice Contracted [320433] $5,531 151%
Elara Caring Aspire Hospice [20433] $5,531 151%
Globalhealth Contracted [320145] $5,531 151%
Halo Hcr Inc Hospice Contracted [320432] $5,531 151%
Halo Hcr Inc Hospice [20432] $5,531 151%
Humana $5,531 151%
Kindful Hospice Contracted [320434] $5,531 151%
Kindful Hospice [20434] $5,531 151%
Medicare (plans) $5,531 - $5,752 151%
Mercy Hospice Okc [20252] $5,531 151%
Pace Of The Ozarks Contracted [320518] $5,531 151%
Qual Choice Contracted [320325] $5,531 151%
Tricare $5,531 151%
Hope Trust Contracted [320488] $5,638 154%
Cigna $5,642 154%
Provider Partners Health Plans Contracted [320450] $6,095 167%
Healthscope Contracted [320182] $7,048 193%
Centivo Contracted [320505] $9,304 254%
Preferred Health Plan Contracted [320522] $9,867 270%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 901 East 5Th Street, Washington, MO 63090
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals