CMS Price Transparency Data

Inguinal hernia repair

Facility: UNM Hospital

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $5,981
Cash Discount Price: $3,307
vs. Medicare Baseline: 1.64x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at UNM Hospital is $5,981. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,307. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 1.64x the Medicare baseline. Located in 2211 Lomas Boulevard Ne, Albuquerque, NM.

Cash / Self-Pay

$3,307

Average discount available for prompt cash payment at this facility.

Insurance Median

$5,981

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: $3,307 (90%)

Insurance Median: $5,981 (164%)

Cash: $3,307 (90% of Medicare)

Ins. Median: $5,981 (164% 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	$457 - $5,981	12%
Humana	$3,174 - $5,382	87%
Aetna	$3,527 - $5,981	96%
Alamo Navajo School Board	$3,527 - $5,981	96%
Indian Health Abq	$3,527 - $5,981	96%
Kewa Pueblo Health Corporation	$3,527 - $5,981	96%
Pueblo Of Isleta	$3,527 - $5,981	96%
Pueblo Of Jemez	$3,527 - $5,981	96%
Pueblo Of Sandia	$3,527 - $5,981	96%
UnitedHealthcare	$3,527 - $5,981	96%
Devoted Health	$4,233 - $7,177	116%
Christus	$5,291 - $8,971	145%
Albuquerque Public Schools	$7,054 - $11,961	193%
Presbyterian Network	$7,054 - $11,961	193%
Christus Health Exchange Plan	$7,936 - $13,456	217%
Imperial Health Exchange	$8,641 - $14,652	236%
Molina	$8,641 - $14,652	236%

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 $3,307.
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 UNM 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.