CMS Price Transparency Data

Inguinal hernia repair

Facility: Lafollette Medical Center

Billing Code: 49505 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$3,488

about 1.0× the $3,658 Medicare rate · typically $3,048–$3,622

modeled estimate · not a bill or quote

What this hospital charges insurers

$3,526

About the fair price

about $38 over the fair price · 1.0× Medicare

Medicare pays $3,658 Fair price $3,488 This hospital $3,526 Cash price $7,326 Hospital's list price $27,132

How we calculate the fair BaseRate →

How this hospital compares to other TN hospitals

Highest price of the 9 TN hospitals we have prices for — worth calling around.

Cheapest $506 Priciest $3,526

Black dot = this hospital, among the 9 TN hospitals with a price for this procedure. Full list below.

A fair price for a Inguinal hernia repair is about $3,488 (about 1.0× the $3,658 Medicare rate). Lafollette Medical Center charges insurers about $3,526, or about $7,326 in cash — about the fair price. Located in La Follette, TN.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$2,408 - $27,132	66%
Blue Cross Blue Shieldmajor	$1,338 - $6,243	37%
Aetnamajor	$3,526 - $16,876	96%
Cignamajor	$12,392	339%
Humanamajor	$3,423 - $5,969	94%
Ambetter (Centene)	$6,436	176%
Amerigroup	$2,263 - $3,595	62%
Cigna HealthSpring	$3,526	96%
Devoted Health	$3,492	95%
WellCare	$3,479 - $6,783	95%
+ 9 smaller / regional plans	$1,015 - $7,654

Government programs also on file: Medicare, Medicaid, Military & VA.

Excludes 3 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 7,326), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 49505.

Insurance Before you use insurance

Call your insurance company to confirm Lafollette Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 49505.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Lafollette Medical Center

Compare: Inguinal hernia repair at other TN hospitals

Rhea Medical Center · Dayton $506
Erlanger Medical Center · Chattanooga $883
Williamson Medical Center · Franklin $1,196
University Health System, Inc · Knoxville $1,298
Dekalb Community Hospital · Smithville $1,941
Saint Thomas Highlands Hospital · Sparta $1,941
Stones River Hospital · Woodbury $1,974
Saint Thomas Hickman Hospital · Centerville $1,974

Insurance negotiated median for the same procedure, sorted lowest first.