CMS Price Transparency Data

Inguinal hernia repair

Facility: Columbia Memorial Hospital

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $601
Cash Discount Price: $639
vs. Medicare Baseline: 0.16x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at Columbia Memorial Hospital is $601. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $639. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.16x the Medicare baseline. Located in 71 Prospect Avenue, Hudson, NY.

Cash / Self-Pay

$639

Average discount available for prompt cash payment at this facility.

Insurance Median

$601

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: $639 (17%)

Insurance Median: $601 (16%)

Cash: $639 (17% of Medicare)

Ins. Median: $601 (16% 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
UnitedHealthcare	$181 - $4,015	5%
Medicaid / KanCare	$234 - $2,480	6%
Mvp	$396 - $5,208	11%
Cdphp	$404 - $5,580	11%
Medicare (plans)	$424 - $565	12%
Blue Cross Blue Shield	$472 - $4,951	13%
Tricare	$480 - $565	13%
Hamaspik	$529 - $3,373	14%
Fidelis	$537 - $5,580	15%
Blue Shield Highmark	$571 - $611	16%
Aetna	$582 - $4,301	16%
Emblem	$703 - $766	19%
Cigna	$724 - $748	20%
Emblem Health Ghi	$774	21%
Magnacare	$983	27%
Multiplan	$1,149	31%
Herrington Diversified Pdh	$1,277	35%
Empire Plan Nyship	$4,951	135%
Mvp Commercial	$5,218	143%
Blue Shield	$6,070 - $7,032	166%

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 $639.
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 Columbia Memorial 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.