CMS Price Transparency Data

Inguinal hernia repair

Facility: Baylor Scott and White Medical Center Lake Pointe

Billing Code: 49505 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$3,800

about 1.0× the $3,658 Medicare rate · typically $3,674–$4,364

modeled estimate · not a bill or quote

What this hospital charges insurers

$3,884

About the fair price

about $84 over the fair price · 1.1× Medicare

Medicare pays $3,658 Fair price $3,800 This hospital $3,884 Cash price $6,211 Hospital's list price $10,351

How we calculate the fair BaseRate →

How this hospital compares to other TX hospitals

Highest price of the 9 TX hospitals we have prices for — worth calling around.

Cheapest $498 Priciest $3,884

Black dot = this hospital, among the 9 TX hospitals with a price for this procedure. Full list below.

A fair price for a Inguinal hernia repair is about $3,800 (about 1.0× the $3,658 Medicare rate). Baylor Scott and White Medical Center Lake Pointe charges insurers about $3,884, or about $6,211 in cash — about the fair price. Located in Rowlett, TX.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$3,639 - $7,153	99%
Blue Cross Blue Shieldmajor	$1,152 - $8,074	31%
Aetnamajor	$13,821	378%
Cignamajor	$5,103 - $7,336	140%
Humanamajor	$3,164 - $7,246	86%
Ambetter (Centene)	$6,550	179%
Baylor Scott & White	$3,006 - $6,004	82%
Cigna HealthSpring	$3,322	91%
Health Net	$5,693	156%
Molina	$3,322	91%
+ 7 smaller / regional plans	$3,322 - $7,763

Government programs also on file: Medicaid, Military & VA.

Excludes 5 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 6,211), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 49505.

Insurance Before you use insurance

Call your insurance company to confirm Baylor Scott and White Medical Center Lake Pointe is in-network.
Ask your insurer whether prior approval is required for CPT code 49505.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Baylor Scott and White Medical Center Lake Pointe

Compare: Inguinal hernia repair at other TX hospitals

Insurance negotiated median for the same procedure, sorted lowest first.