CMS Price Transparency Data

Inguinal hernia repair

Facility: University Health System, Inc

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $1,298
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.35x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at University Health System, Inc is $1,298. 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 0.35x the Medicare baseline. Located in 1924 Alcoa Highway, Knoxville, TN.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,298

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: $1,298 (35%)

Ins. Median: $1,298 (35% 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
Tenncare	$346 - $407	9%
Blue Cross Blue Shield	$375 - $3,384	10%
Bluecare	$380 - $407	10%
Aetna	$475 - $3,351	13%
Choicecare	$476 - $613	13%
Humana	$476 - $3,222	13%
Nhc	$476 - $3,416	13%
UnitedHealthcare	$476 - $4,752	13%
Cigna	$480 - $3,222	13%
American Health	$489 - $3,416	13%
Coventry	$625 - $2,390	17%
Multiplan	$625	17%
Initial Group	$649	18%
First Health	$688	19%
Beechstreet	$744	20%
Novanet	$844	23%
Wellpoint	$2,514 - $3,416	69%
Devoted Health	$3,351	92%
Wellcare-Windsor Medadv	$3,384	93%
Medicare (plans)	$3,416 - $3,448	93%

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 University Health System, 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.