CMS Price Transparency Data

Inguinal hernia repair

Facility: Bertrand Chaffee Hospital

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $491
Cash Discount Price: $654
vs. Medicare Baseline: 0.13x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at Bertrand Chaffee Hospital is $491. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $654. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.13x the Medicare baseline. Located in 224 East Main Street, Springville, NY.

Cash / Self-Pay

$654

Average discount available for prompt cash payment at this facility.

Insurance Median

$491

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: $654 (18%)

Insurance Median: $491 (13%)

Cash: $654 (18% of Medicare)

Ins. Median: $491 (13% 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
Medicare (plans)	$488 - $491	13%
Tricare	$488 - $491	13%
Advantra-Mcr Advantage	$491	13%
Aetna	$491 - $770	13%
Centers Plan Hlty Living	$491	13%
Champva	$491	13%
Cigna	$491 - $770	13%
Ctrs Plan For Hlthy Livng	$491	13%
Geisinger Health Plan	$491	13%
Humana	$491	13%
Iha Encompass 65	$491	13%
Lifetime Benefits	$491	13%
Mutual Of Omaha	$491	13%
Optimum Healthcare - Mcr	$491	13%
Todays Option - Amer Prog	$491	13%
United Hc Mcr Solutions	$491	13%
UnitedHealthcare	$491	13%
Wellcare	$491	13%
Blue Cross Blue Shield	$608 - $2,780	17%
Private Pay	$654	18%
American Progressive Ins.	$770	21%
Commercial / Misc	$770	21%
Global Excel Mgt	$770	21%
Guardian Life Ins. Co.	$770	21%
Mvp Commercial	$770	21%
No Amer Meritian Health	$770	21%
No-Fault	$770	21%
Nova Healthcare	$770	21%
Univera Healthcare	$1,218	33%
Univera Senior Choice	$1,218	33%
Senior Blue - Bc	$1,984	54%

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 $654.
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 Bertrand Chaffee 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.