CMS Price Transparency Data

Inguinal hernia repair

Facility: Mercy Hospital Oklahoma City, Inc

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $3,293
Cash Discount Price: $7,869
vs. Medicare Baseline: 0.90x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at Mercy Hospital Oklahoma City, Inc is $3,293. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,869. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.90x the Medicare baseline. Located in 4300 West Memorial Road, Oklahoma City, OK.

Cash / Self-Pay

$7,869

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,293

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: $7,869 (215%)

Insurance Median: $3,293 (90%)

Cash: $7,869 (215% of Medicare)

Ins. Median: $3,293 (90% 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
Medicaid / KanCare	$363 - $4,532	10%
Blue Cross Blue Shield	$488 - $3,529	13%
Tricare	$3,125 - $3,293	85%
Aetna	$3,143 - $3,293	86%
Humana	$3,143 - $3,293	86%
Champva [20065]	$3,293	90%
Cherokee Nation Health Serv Contracted [320066]	$3,293	90%
Cross Timbers Hospice [20098]	$3,293	90%
Dept Of Veteran Affairs Contracted [320106]	$3,293	90%
Elara Caring Aspire Hospice Contracted [320433]	$3,293	90%
Elara Caring Aspire Hospice [20433]	$3,293	90%
Halo Hcr Inc Hospice Contracted [320432]	$3,293	90%
Halo Hcr Inc Hospice [20432]	$3,293	90%
Indian Health Service Contracted [320198]	$3,293	90%
Kindful Hospice Contracted [320434]	$3,293	90%
Kindful Hospice [20434]	$3,293	90%
Medicare (plans)	$3,293 - $3,525	90%
Mercy Hospice Okc [20252]	$3,293	90%
Mercy Rehab Hospital Contracted [320260]	$3,293	90%
Provider Partners Health Plans Contracted [320450]	$3,293	90%
Qual Choice Contracted [320325]	$3,293	90%
UnitedHealthcare	$3,293	90%
Globalhealth Contracted [320145]	$3,360	92%
Cigna	$3,394	93%
Amg Spec Hosp Edmond [20034]	$3,525	96%
Ambetter / Centene	$4,532	124%
Home State Health Plan Contracted [320187]	$4,532	124%
Novasys Contracted [320285]	$4,532	124%
Community Care Contracted [320080]	$5,035	138%
Workers Comp [20426]	$5,161	141%
Health Choice Contracted [320166]	$6,352	174%
Healthsmart Preferred Care Contracted [320184]	$7,410	203%
Kempton Contracted [320214]	$7,410	203%

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 $7,869.
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 Mercy Hospital Oklahoma City, Inc 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.