CMS Price Transparency Data

Inguinal hernia repair

Facility: Mary Lanning Healthcare

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $706
Cash Discount Price: $1,182
vs. Medicare Baseline: 0.19x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at Mary Lanning Healthcare is $706. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,182. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.19x the Medicare baseline. Located in 715 N St Joseph Ave, Hastings, NE.

Cash / Self-Pay

$1,182

Average discount available for prompt cash payment at this facility.

Insurance Median

$706

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: $1,182 (32%)

Insurance Median: $706 (19%)

Cash: $1,182 (32% of Medicare)

Ins. Median: $706 (19% 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
Tricare	$424	12%
Aetna	$452 - $467	12%
Blue Cross Blue Shield	$452 - $840	12%
Medica Mcr Adv	$452	12%
Ne Total Care Mcr Adv	$452	12%
UnitedHealthcare	$452 - $713	12%
Va Ccn - All Plans	$452	12%
Consociate Inc-All Plans	$700	19%
Ambetter / Centene	$745	20%
Medica-All Other Plans	$790	22%
Nhn/Mna-All Plans	$858	23%
Workers Compensation-All Plans	$1,081	30%
Midlands Choice-All Plans	$1,114	30%
Multiplan-All Plans	$1,182	32%
Provider Network Of America-All Plans	$1,182	32%

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 $1,182.
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 Mary Lanning Healthcare 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.