CMS Price Transparency Data

Inguinal hernia repair

Facility: Cheshire Medical Center

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $3,272
Cash Discount Price: $1,872
vs. Medicare Baseline: 0.89x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at Cheshire Medical Center is $3,272. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,872. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.89x the Medicare baseline. Located in 580 Court Street, Keene, NH.

Cash / Self-Pay

$1,872

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,272

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: $1,872 (51%)

Insurance Median: $3,272 (89%)

Cash: $1,872 (51% of Medicare)

Ins. Median: $3,272 (89% 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
Aetna	$283 - $4,638	8%
Ambetter / Centene	$439 - $3,278	12%
Blue Cross Blue Shield	$439 - $11,968	12%
Cigna	$439 - $6,627	12%
Martin'S Point Generations Advantage	$439 - $3,687	12%
Martin'S Point Health Care	$439 - $3,687	12%
Mvp	$439 - $6,627	12%
UnitedHealthcare	$439 - $5,557	12%
Wellcare Health Plans	$439 - $3,687	12%
Wellsense Health Plan	$439 - $3,946	12%
Amerihealth Caritas Nh	$459 - $830	13%
Granite State Health Plan	$459 - $1,132	13%
Harvard Pilgrim Health Care Of Ne	$1,444 - $7,159	39%
Tufts Health Plan	$1,602 - $4,328	44%
Mass General Brigham Health Plan	$2,685 - $6,781	73%
Maine Community Health Options	$3,051	83%
First Health/Hcvm	$5,764	158%
Phcs	$6,103	167%

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 $1,872.
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 Cheshire Medical Center 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.