CMS Price Transparency Data

Inguinal hernia repair

Facility: UT of Texas Southwestern University Hospital - William P. Clements Jr.

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $1,222
Cash Discount Price: $1,424
vs. Medicare Baseline: 0.33x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at UT of Texas Southwestern University Hospital - William P. Clements Jr. is $1,222. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,424. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.33x the Medicare baseline. Located in 6201 Harry Hines Blvd, Dallas, TX.

Cash / Self-Pay

$1,424

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,222

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: $1,424 (39%)

Insurance Median: $1,222 (33%)

Cash: $1,424 (39% of Medicare)

Ins. Median: $1,222 (33% 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
Molina	$423 - $3,706	12%
Parkland	$423 - $1,152	12%
UnitedHealthcare	$423 - $15,883	12%
Wellpoint	$423 - $3,706	12%
Aetna	$486 - $1,889	13%
Superior	$495 - $3,706	14%
Procare	$512 - $3,529	14%
Ambetter / Centene	$523	14%
Blue Cross Blue Shield	$537 - $13,737	15%
Humana	$537 - $3,670	15%
Healthfirst	$1,003	27%
Coventry	$1,024	28%
Quiktrip	$1,152	31%
Maestro Health/Fort Worth Firefighters	$1,181	32%
Rockwall County	$1,329	36%
United Options Nexus	$1,510 - $20,334	41%
Cigna	$1,566	43%
Phcs	$1,580	43%
Galaxy Health Network	$1,708	47%
Multiplan	$1,708	47%
Healthsmart	$2,317	63%

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 $1,424.
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 UT of Texas Southwestern University Hospital - William P. Clements Jr. 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.