CMS Price Transparency Data

Inguinal hernia repair

Facility: Artesia General Hospital

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $1,011
Cash Discount Price: $652
vs. Medicare Baseline: 0.28x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at Artesia General Hospital is $1,011. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $652. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.28x the Medicare baseline. Located in 702 N 13Th Street, Artesia, NM.

Cash / Self-Pay

$652

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,011

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: $652 (18%)

Insurance Median: $1,011 (28%)

Cash: $652 (18% of Medicare)

Ins. Median: $1,011 (28% 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
Zelis	$297 - $4,104	8%
First Health	$420 - $4,401	11%
Blue Cross Blue Shield	$652 - $3,420	18%
Geha	$761 - $3,420	21%
Omni Networks	$761	21%
Three Rivers Provider Network	$815	22%
Cigna	$924 - $978	25%
Galaxy Health	$978	27%
One Health Plan	$978	27%
Multiplan	$989	27%
United Payors & United Providers	$1,011	28%
Providence Risk & Insurance Services	$1,033 - $6,839	28%
Molina Healthcare Of New Mexico	$2,613 - $5,745	71%
Presbyterian Health Plan	$2,613 - $3,420	71%
UnitedHealthcare	$2,613 - $3,420	71%
Triwest	$3,351	92%
Humana	$3,420 - $3,762	93%
Vistacare Hospice	$3,420	93%
New Mexico Health Connections	$5,813	159%

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 $652.
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 Artesia General 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.