CMS Price Transparency Data

Inguinal hernia repair

Facility: Lafollette Medical Center

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $3,526
  • Cash Discount Price: $7,326
  • vs. Medicare Baseline: 0.96x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Lafollette Medical Center is $3,526. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,326. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.96x the Medicare baseline. Located in 923 East Central Avenue, La Follette, TN.
Cash / Self-Pay
$7,326

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,526

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: $7,326 (200%)
Insurance Median: $3,526 (96%)
Cash: $7,326 (200% of Medicare)
Ins. Median: $3,526 (96% 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.

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
Veterans Eval Services $466 13%
Bluecare $1,015 - $1,539 28%
Blue Cross Blue Shield $1,338 - $6,243 37%
Amerigroup $2,263 62%
Medicaid / KanCare $2,408 - $6,783 66%
UnitedHealthcare $2,408 - $27,132 66%
Tricare $3,173 87%
Node Champva $3,340 91%
Triwest $3,409 93%
Humana $3,423 - $5,969 94%
Medicare (plans) $3,423 94%
Node Bluecare Plus Tn Mcr Adv $3,423 94%
Node Hospice Non Par Agree $3,479 95%
Node Va $3,479 95%
Node Wellcare Mcr Adv $3,479 95%
Node Devoted Health Mcr Adv $3,492 95%
Node Farm Bureau Mcr Adv $3,492 95%
Aetna $3,526 - $16,876 96%
Node Blueadvantage Mcr Adv $3,526 96%
Node Healthspring Mcr Adv $3,526 96%
Node Amerigroup Mcr Adv $3,595 98%
Windsor Health Plan $3,595 98%
Node Nhc Mcr Adv $3,766 103%
Node Us Dept Of Labor $4,349 119%
Novanet Work Comp Tn $5,241 143%
Tn Work Comp $5,294 145%
Ambetter / Centene $6,436 176%
Wellcare $6,783 185%
Node Point Comfort Underwriters $7,654 209%
Self Pay $7,790 213%
Cigna $12,392 339%
Multiplan Complementary $20,620 564%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 923 East Central Avenue, La Follette, TN 37766
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals