CMS Price Transparency Data

Inguinal hernia repair

Facility: Christus St Michael Health System

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $3,464
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.95x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at Christus St Michael Health System is $3,464. 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 0.95x the Medicare baseline. Located in 2600 St Michael Dr, Texarkana, TX.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,464

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: $3,464 (95%)

Ins. Median: $3,464 (95% 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
Arkansas Total Care	$363	10%
Empower Healthcare Solutions	$370	10%
UnitedHealthcare	$485 - $10,839	13%
Amerigroup	$1,152 - $3,742	31%
Superior	$1,152	31%
Texas True Choice	$1,152	31%
Summit Community Care	$1,175	32%
Molina	$1,209 - $3,464	33%
Texas Children'S Health Plan	$1,209	33%
Humana	$2,922 - $3,464	80%
Blue Cross Blue Shield	$3,389 - $8,240	93%
Aetna	$3,464 - $6,753	95%
Christus Health	$3,464 - $4,850	95%
Coventry	$3,464	95%
Texas Healthspring	$3,464	95%
Triwest	$3,464	95%
Windsor	$3,464	95%
Provider Partners Health Plan	$3,568	98%
Texas Independence Health Plan	$3,568	98%
Shared Health Insurance Company	$3,638	99%
Tribute Health Plan	$3,638	99%
State Of Oklahoma	$3,650	100%
Us Imaging Network	$3,707	101%
Imperial Health Plan	$3,811	104%
Medicare (plans)	$3,811	104%
Procare Advantage	$3,811	104%
Five Point Credit Union	$4,020	110%
Healthcare Highways	$4,941	135%
Qualchoice	$5,210	142%
Naphcare Inc.	$6,929	189%
Cigna	$7,191	197%

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 $X.
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 Christus St Michael Health System 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.