CMS Price Transparency Data

Inguinal hernia repair

Facility: The Heart Hospital Baylor Denton

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $5,693
  • Cash Discount Price: $6,211
  • vs. Medicare Baseline: 1.56x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at The Heart Hospital Baylor Denton is $5,693. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,211. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 1.56x the Medicare baseline. Located in 2801 South Mayhill Road, Denton, TX.
Cash / Self-Pay
$6,211

Average discount available for prompt cash payment at this facility.

Insurance Median
$5,693

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: $6,211 (170%)
Insurance Median: $5,693 (156%)
Cash: $6,211 (170% of Medicare)
Ins. Median: $5,693 (156% 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
Superior Health Plan $1,152 - $3,333 31%
Baylor Scott & White Health Plan $3,015 - $6,004 82%
Humana $3,174 - $7,246 87%
Triwest $3,174 87%
Corvel $3,325 91%
Prime Health Services $3,325 91%
American Health Plan $3,333 91%
Blue Cross Blue Shield $3,333 - $8,074 91%
Healthspring $3,333 91%
Procare Advantage $3,333 91%
UnitedHealthcare $3,650 - $7,153 100%
Cigna $5,103 - $6,004 140%
Employers Health Network $5,693 156%
Quiktrip $5,693 156%
University Of Mary Hardin-Baylor $6,004 164%
Imagine Health $6,484 177%
Ambetter / Centene $6,570 180%
Curative $6,728 184%
First Health $7,246 198%
Healthsmart $7,564 - $7,763 207%
Private Health Care System $7,763 212%
Aetna $15,335 419%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2801 South Mayhill Road, Denton, TX 76208
  • CMS Rating: ★★★★★
  • Ownership Type: Physician
  • Hospital Type: Acute Care Hospitals