CMS Price Transparency Data

Inguinal hernia repair

Facility: Barnes-Jewish St Peters Hospital

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $7,193
Cash Discount Price: $13,280
vs. Medicare Baseline: 1.97x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at Barnes-Jewish St Peters Hospital is $7,193. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $13,280. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 1.97x the Medicare baseline. Located in 10 Hospital Dr, Saint Peters, MO.

Cash / Self-Pay

$13,280

Average discount available for prompt cash payment at this facility.

Insurance Median

$7,193

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: $13,280 (363%)

Insurance Median: $7,193 (197%)

Cash: $13,280 (363% of Medicare)

Ins. Median: $7,193 (197% 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.

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]	$4,697	128%
Sarah Bush Lincoln [636]	$4,697 - $7,193	128%
Blue Cross Blue Shield	$5,558 - $7,630	152%
Cigna	$5,710 - $10,962	156%
UnitedHealthcare	$6,081 - $7,193	166%
Humana	$6,690	183%
Healthscope Benefits [258]	$7,193	197%
Aetna	$9,085	248%
Allied Benefits [498]	$9,085	248%
Coresource [497]	$9,085	248%
Fmh Benefit Service Inc [222]	$9,085	248%
Mail Handlers [495]	$9,085	248%
Apwu Health Plan [216]	$10,962	300%
Nalc Health Benefit Plan [242]	$10,962	300%
Priority Health [648]	$10,962	300%

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 $13,280.
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 St Peters 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.