CMS Price Transparency Data

Inguinal hernia repair

Facility: Legacy Good Samaritan Medical Center

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $9,582
Cash Discount Price: $969
vs. Medicare Baseline: 2.62x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at Legacy Good Samaritan Medical Center is $9,582. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $969. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 2.62x the Medicare baseline. Located in 1015 Nw 22Nd Avenue, W121, Portland, OR.

Cash / Self-Pay

$969

Average discount available for prompt cash payment at this facility.

Insurance Median

$9,582

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: $969 (26%)

Insurance Median: $9,582 (262%)

Cash: $969 (26% of Medicare)

Ins. Median: $9,582 (262% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 262% of the Medicare baseline (a markup of 162%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Kaiser	$3,980 - $7,959	109%
Atrio	$4,099	112%
Aetna	$4,179 - $13,746	114%
Healthnet	$4,218 - $10,400	115%
Careoregon	$4,298	117%
Ageright	$4,378	120%
Moda	$4,457 - $15,392	122%
Blue Cross Blue Shield	$8,764 - $12,846	240%
Cigna	$12,664 - $16,275	346%
UnitedHealthcare	$12,835	351%
First Health	$16,328	446%

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 $969.
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 Legacy Good Samaritan Medical Center 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.