CMS Price Transparency Data

Inguinal hernia repair

Facility: Physicians Regional Medical Center

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $3,260
  • Cash Discount Price: $5,678
  • vs. Medicare Baseline: 0.89x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Physicians Regional Medical Center is $3,260. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,678. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.89x the Medicare baseline. Located in 7565 Dannaher Way Powell, Powell, TN.
Cash / Self-Pay
$5,678

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,260

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: $5,678 (155%)
Insurance Median: $3,260 (89%)
Cash: $5,678 (155% of Medicare)
Ins. Median: $3,260 (89% 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%
Blue Cross Blue Shield $1,222 - $6,090 33%
Amerigroup $2,125 - $3,356 58%
Amerigroup Community Care $2,125 58%
Medicaid / KanCare $2,255 62%
UnitedHealthcare $2,255 - $23,314 62%
Aetna $2,600 - $3,292 71%
Tricare $3,086 84%
Humana $3,196 87%
Medicare (plans) $3,196 87%
Node Bluecare Plus Tn Mcr Adv $3,196 - $3,248 87%
Department Of Veterans Affairs $3,248 89%
Node Hospice Non Par Agree $3,248 89%
Node Va $3,248 89%
Node Devoted Health Mcr Adv $3,260 89%
Node Farm Bureau Mcr Adv $3,260 89%
Node Healthspring Mcr Adv $3,292 90%
Wellcare $3,378 92%
Node Nhc Mcr Adv $3,516 96%
Node Us Dept Of Labor $4,061 111%
Us Department Of Labor $4,061 111%
Novanet Work Comp Tn $5,241 143%
Self Pay $5,281 - $6,075 144%
Occunet Work Comp Tn $5,294 145%
Tn Work Comp $5,294 145%
Ambetter / Centene $6,010 164%
Node Point Comfort Underwriters $6,010 164%
Cigna $7,410 - $7,492 203%
Multiplan $12,590 - $19,820 344%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7565 Dannaher Way Powell, Powell, TN 37849
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals