CMS Price Transparency Data

Inguinal hernia repair

Facility: Coastal Carolina Hospital

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $3,430
Cash Discount Price: $1,926
vs. Medicare Baseline: 0.94x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at Coastal Carolina Hospital is $3,430. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,926. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.94x the Medicare baseline. Located in 1000 Medical Center Drive, Hardeeville, SC.

Cash / Self-Pay

$1,926

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,430

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: $1,926 (53%)

Insurance Median: $3,430 (94%)

Cash: $1,926 (53% of Medicare)

Ins. Median: $3,430 (94% 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
Humana	$1,339 - $3,330	37%
Molina	$1,339 - $5,495	37%
Select Health	$1,339 - $6,360	37%
Absolute Total Care	$1,406 - $5,495	38%
Blue Cross Blue Shield	$1,926 - $9,488	53%
Aetna	$3,330	91%
Devoted Health	$3,330	91%
UnitedHealthcare	$3,330 - $29,774	91%
Cigna	$3,430	94%
Clover Insurance Company	$3,463	95%

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 $1,926.
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 Coastal Carolina 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.