CMS Price Transparency Data

Inguinal hernia repair

Facility: Memorial Community Hospital & Health System

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $617
Cash Discount Price: $950
vs. Medicare Baseline: 0.17x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at Memorial Community Hospital & Health System is $617. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $950. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.17x the Medicare baseline. Located in 810 North 22Nd St, Blair, NE.

Cash / Self-Pay

$950

Average discount available for prompt cash payment at this facility.

Insurance Median

$617

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: $950 (26%)

Insurance Median: $617 (17%)

Cash: $950 (26% of Medicare)

Ins. Median: $617 (17% 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
Blue Cross Blue Shield	$68 - $918	2%
Tricare	$452	12%
UnitedHealthcare	$452 - $1,098	12%
Humana	$461	13%
Ne Total Care Comm Exch Op/Profee Only	$479	13%
Medica Mcr Adv	$519	14%
Ne Total Care Mcaid-All Other Plans	$605	17%
Medicaid / KanCare	$617 - $641	17%
Aetna	$813 - $1,011	22%
Medica Comm-All Other Plans	$835	23%
Midlands Choice-All Plans	$1,025	28%
Multiplan (Phcs)-All Plans	$1,296	35%

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 $950.
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 Memorial Community Hospital & Health System 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.