CMS Price Transparency Data

Inguinal hernia repair

Facility: St Joseph Medical Center

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $3,658
  • Cash Discount Price: $3,568
  • vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at St Joseph Medical Center is $3,658. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,568. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 1.00x the Medicare baseline. Located in 1000 Carondelet Dr, Kansas City, MO.
Cash / Self-Pay
$3,568

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,658

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: $3,568 (98%)
Insurance Median: $3,658 (100%)
Cash: $3,568 (98% of Medicare)
Ins. Median: $3,658 (100% 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 $1,403 - $6,602 38%
Medicaid / KanCare $3,008 82%
Home State $3,430 - $5,710 94%
UnitedHealthcare $3,490 - $11,227 95%
Aetna $3,569 - $4,081 98%
Cigna $3,569 98%
Medicare (plans) $3,569 - $3,747 98%
Pace Kc (Swope Health Services) $3,569 98%
Tricare $3,569 98%
Veterans Evaluation Services $3,569 98%
Healthy Blue $3,747 - $4,001 102%
Kansas Superior $3,747 102%
Nhc Advantage $3,925 107%
Employer Direct Healthcare $4,996 137%
6 Degrees $7,137 195%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Carondelet Dr, Kansas City, MO 64114
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals