CMS Price Transparency Data

Inguinal hernia repair

Facility: Methodist Fremont Health

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $5,869
Cash Discount Price: $3,406
vs. Medicare Baseline: 1.60x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at Methodist Fremont Health is $5,869. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,406. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 1.60x the Medicare baseline. Located in 450 East 23Rd St, Fremont, NE.

Cash / Self-Pay

$3,406

Average discount available for prompt cash payment at this facility.

Insurance Median

$5,869

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: $3,406 (93%)

Insurance Median: $5,869 (160%)

Cash: $3,406 (93% of Medicare)

Ins. Median: $5,869 (160% 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
Elevate By Medica	$2,810 - $5,475	77%
Alliance Nhn	$3,634 - $7,081	99%
Aetna	$3,918 - $11,679	107%
Blue Cross Blue Shield	$3,918 - $10,889	107%
Humana	$3,918	107%
Medica	$3,918	107%
Medicare (plans)	$3,918 - $3,996	107%
UnitedHealthcare	$3,918 - $10,962	107%
Ne Furniture Mart	$5,183 - $10,098	142%
Medica Choice	$5,495 - $10,706	150%
Multiplan	$5,620 - $10,949	154%
Midlands Choice	$5,869 - $11,436	160%
Ambetter / Centene	$8,111	222%
Elite Choice	$8,123	222%

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 $3,406.
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 Methodist Fremont Health 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.