CMS Price Transparency Data

Inguinal hernia repair

Facility: Christus Mother Frances Hospital

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $3,336
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.91x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Christus Mother Frances Hospital is $3,336. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.91x the Medicare baseline. Located in 800 East Dawson, Tyler, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,336

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%)
Insurance Median: $3,336 (91%)
Ins. Median: $3,336 (91% 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
Amerigroup $1,152 - $3,603 31%
Superior $1,152 31%
Molina $1,209 33%
Texas Childrens Health Plan $1,209 33%
UnitedHealthcare $1,209 - $6,942 33%
Humana $2,659 - $3,336 73%
Aetna $3,336 91%
Allwell $3,336 91%
Blue Cross Blue Shield $3,336 - $5,472 91%
Christus Health $3,336 - $4,670 91%
Cigna $3,336 - $17,425 91%
Triwest $3,336 91%
Washington National $3,336 91%
Wellcare $3,336 91%
Peoples Health $3,436 94%
Provider Partners Health Plan $3,436 94%
Shared Health Insurance Company $3,503 96%
Imperial Health Plan $3,669 100%
Medicare (plans) $3,669 100%
Procare Advantage $3,669 100%
Naphcare Inc. $6,671 182%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 800 East Dawson, Tyler, TX 75701
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals