CMS Price Transparency Data

Inguinal hernia repair

Facility: Erlanger Medical Center

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $845
Cash Discount Price: $559
vs. Medicare Baseline: 0.23x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at Erlanger Medical Center is $845. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $559. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.23x the Medicare baseline. Located in 975 E 3Rd St, Chattanooga, TN.

Cash / Self-Pay

$559

Average discount available for prompt cash payment at this facility.

Insurance Median

$845

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: $559 (15%)

Insurance Median: $845 (23%)

Cash: $559 (15% of Medicare)

Ins. Median: $845 (23% 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
Bluecare	$346 - $3,367	9%
Amerigroup	$364 - $1,406	10%
Caresource	$364 - $6,475	10%
Peach State Hlth Plan	$364	10%
Blue Cross Blue Shield	$395 - $3,446	11%
Humana	$417 - $3,237	11%
UnitedHealthcare	$435 - $3,399	12%
Cigna	$460 - $3,237	13%
Alexian	$676 - $3,237	18%
Clover	$676 - $3,237	18%
Medicare (plans)	$676	18%
Upmc	$676 - $3,237	18%
Aetna	$679 - $3,334	19%
Pruitthealth Premier	$692	19%
American Health	$697 - $3,334	19%
Devoted Health	$703 - $3,367	19%
Nhc	$710 - $3,399	19%
Atrio Health	$744 - $3,561	20%
Simpra Advantage	$744	20%
Ambetter / Centene	$845 - $4,047	23%
Caresource Ga	$924 - $1,656	25%
Caresource Tn	$924 - $1,656	25%
Olympus	$1,014 - $1,150	28%
Pnoa	$1,022 - $8,093	28%
Alliant	$1,082	30%
Caresource Nc	$1,115 - $1,656	30%
Occunet	$1,183 - $3,075	32%
Point Comfort Underwriters	$1,186 - $1,217	32%
Wellpoint	$3,323	91%

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 $559.
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 Erlanger Medical Center 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.