CMS Price Transparency Data

Inguinal hernia repair

Facility: Mercy Hospital Southeast

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $5,698
  • Cash Discount Price: $19,211
  • vs. Medicare Baseline: 1.56x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Mercy Hospital Southeast is $5,698. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $19,211. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 1.56x the Medicare baseline. Located in 1701 Lacey St, Cape Girardeau, MO.
Cash / Self-Pay
$19,211

Average discount available for prompt cash payment at this facility.

Insurance Median
$5,698

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: $19,211 (525%)
Insurance Median: $5,698 (156%)
Cash: $19,211 (525% of Medicare)
Ins. Median: $5,698 (156% 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 - $33,009 13%
Indian Health Service Contracted [320198] $477 13%
Medicaid / KanCare $3,008 - $5,415 82%
Imagine 360 Contracted [320494] $3,761 103%
UnitedHealthcare $4,513 - $38,386 123%
Aetna $5,590 153%
Cross Timbers Hospice [20098] $5,590 153%
Dept Of Veteran Affairs Contracted [320106] $5,590 153%
Elara Caring Aspire Hospice Contracted [320433] $5,590 153%
Elara Caring Aspire Hospice [20433] $5,590 153%
Halo Hcr Inc Hospice Contracted [320432] $5,590 153%
Halo Hcr Inc Hospice [20432] $5,590 153%
Humana $5,590 153%
Kindful Hospice Contracted [320434] $5,590 153%
Kindful Hospice [20434] $5,590 153%
Medicare (plans) $5,590 - $5,875 153%
Mercy Hospice Okc [20252] $5,590 153%
Pace Of The Ozarks Contracted [320518] $5,590 153%
Tricare $5,590 153%
Ambetter / Centene $5,698 156%
American Health Advantage Of Mo Mcr Hmo Contracted [320264] $5,698 156%
Home State Health Plan Contracted [320187] $5,698 156%
Hope Trust Contracted [320488] $5,698 156%
Provider Partners Health Plans Contracted [320450] $6,429 176%
Consociate Consolidated Health Contracted [320490] $7,826 - $12,578 214%
Auxiant Contracted [320462] $9,402 - $11,180 257%
Centivo Contracted [320505] $9,402 257%
Ebms Contracted [320493] $9,402 257%
Healthlink Contracted [320179] $9,402 - $12,578 257%
Mercy Benefit Admin Contracted [320251] $9,402 257%
Reflect Health Contracted [320492] $9,744 266%
Preferred Health Plan Contracted [320522] $9,972 273%
Cigna $14,290 391%
United Medical Resources Contracted [320454] $38,386 1049%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1701 Lacey St, Cape Girardeau, MO 63701
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals