CMS Price Transparency Data

Inguinal hernia repair

Facility: Yoakum County Hospital

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $5,256
Cash Discount Price: $7,509
vs. Medicare Baseline: 1.44x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at Yoakum County Hospital is $5,256. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,509. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 1.44x the Medicare baseline. Located in 412 Mustang Avenue, Denver City, TX.

Cash / Self-Pay

$7,509

Average discount available for prompt cash payment at this facility.

Insurance Median

$5,256

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: $7,509 (205%)

Insurance Median: $5,256 (144%)

Cash: $7,509 (205% of Medicare)

Ins. Median: $5,256 (144% 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
90 Degree Benefits	$562	15%
Cigna	$2,000	55%
Insurance Services Of Lubbock	$3,200	87%
Humana	$4,881	133%
UnitedHealthcare	$4,881 - $6,007	133%
Firstcare	$4,956 - $5,256	135%
Multiplan	$4,956 - $6,570	135%
Aetna	$4,978 - $6,383	136%
Dars	$5,256	144%
Healthsmart	$6,345	173%
Phcs	$6,383	174%
Capstar	$6,758	185%
Provider Network	$7,321	200%
Blue Cross Blue Shield	$7,509	205%

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 $7,509.
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 Yoakum County Hospital 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.