CMS Price Transparency Data

Inguinal hernia repair

Facility: Christus Mother Frances Hospital Sulphur Springs

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $3,635
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.99x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Christus Mother Frances Hospital Sulphur Springs is $3,635. 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 0.99x the Medicare baseline. Located in 115 Airport Rd, Sulphur Springs, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,635

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: $3,635 (99%)
Ins. Median: $3,635 (99% 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 - $3,926 31%
Superior $1,152 31%
Molina $1,209 33%
Texas Childrens Health Plan $1,209 33%
UnitedHealthcare $1,209 - $3,635 33%
Allwell $3,635 99%
Blue Cross Blue Shield $3,635 - $6,996 99%
Christus Health $3,635 - $5,089 99%
Cigna $3,635 99%
Humana $3,635 99%
Triwest $3,635 99%
Washington National $3,635 99%
Wellcare $3,635 99%
Aetna $3,671 100%
Peoples Health $3,744 102%
Provider Partners Health Plan $3,744 102%
Shared Health Insurance Company $3,817 104%
Imperial Health Plan $3,998 109%
Medicare (plans) $3,998 109%
Procare Advantage $3,998 109%
Naphcare Inc. $7,270 199%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 115 Airport Rd, Sulphur Springs, TX 75482
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals