CMS Price Transparency Data

Inguinal hernia repair

Facility: Texoma Medical Center

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $3,279
Cash Discount Price: $4,695
vs. Medicare Baseline: 0.90x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at Texoma Medical Center is $3,279. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,695. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.90x the Medicare baseline. Located in 5016 S Us Highway 75, Denison, TX.

Cash / Self-Pay

$4,695

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,279

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: $4,695 (128%)

Insurance Median: $3,279 (90%)

Cash: $4,695 (128% of Medicare)

Ins. Median: $3,279 (90% 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
Superior	$1,175 - $1,272	32%
Molina	$1,272 - $4,445	35%
Tchp	$1,272 - $7,655	35%
Aetna	$1,753	48%
Amerigroup	$1,950	53%
United_Healthcare	$1,950 - $7,655	53%
Cigna	$2,310 - $6,352	63%
Blue_Cross_Blue_Shield_Of_Tx	$4,073 - $5,037	111%
Multiplan	$4,445	122%
Healthchoice	$4,695 - $6,352	128%
Healthsmart	$4,695 - $6,146	128%
Humana	$6,146	168%

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 $4,695.
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 Texoma 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.