CMS Price Transparency Data

Inguinal hernia repair

Facility: Prisma Health Greer Memorial Hospital

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $3,008
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.82x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at Prisma Health Greer Memorial Hospital is $3,008. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.82x the Medicare baseline. Located in 1413 John B White Sr Blvd Suite D, Spartanburg, SC.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,008

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%)

Insurance Median: $3,008 (82%)

Ins. Median: $3,008 (82% 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
Blue Choice Healthplan Of Sc	$308 - $1,780	8%
Medicaid / KanCare	$335 - $1,912	9%
Bluechoice Healthplan Of Sc	$348 - $11,969	10%
Molina	$355 - $3,283	10%
Select Health	$355 - $3,215	10%
Humana	$358 - $2,881	10%
Tricare	$497 - $3,033	14%
Choicecare Network	$507 - $3,103	14%
Wellpath Select Inc	$682 - $4,161	19%
Sc Workers Compensation	$696 - $4,246	19%
Medicare (plans)	$1,555 - $3,184	43%
Blue Cross Blue Shield	$2,054 - $11,407	56%
Veterans Administration	$3,033	83%
Cigna	$3,133	86%
Liberty Advantage	$3,133	86%
UnitedHealthcare	$3,139 - $15,353	86%
Absolute Total Care Prime	$3,184	87%
Aetna	$3,184	87%
Windsor Health Plan	$3,184	87%
Celtic Insurance Company	$5,307	145%

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 $X.
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 Prisma Health Greer 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.