CMS Price Transparency Data

Inguinal hernia repair

Facility: Baylor Scott & White Medical Center - Round Rock

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $5,132
Cash Discount Price: $8,365
vs. Medicare Baseline: 1.40x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at Baylor Scott & White Medical Center - Round Rock is $5,132. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8,365. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 1.40x the Medicare baseline. Located in 300 University Blvd, Round Rock, TX.

Cash / Self-Pay

$8,365

Average discount available for prompt cash payment at this facility.

Insurance Median

$5,132

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: $8,365 (229%)

Insurance Median: $5,132 (140%)

Cash: $8,365 (229% of Medicare)

Ins. Median: $5,132 (140% 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
Blue Cross Blue Shield	$66 - $5,597	2%
Superior Health Plan	$1,152 - $3,095	31%
Baylor Scott & White Health Plan	$2,940 - $5,967	80%
Humana	$3,095 - $9,760	85%
Triwest	$3,095	85%
Corvel	$3,242	89%
Prime Health Services	$3,242	89%
Aetna	$3,249 - $10,200	89%
American Health Plan	$3,249	89%
Healthspring	$3,249	89%
Procare Advantage	$3,249	89%
UnitedHealthcare	$3,559 - $6,874	97%
Injury Management Organization	$3,843	105%
Careworks Fka Rockport	$4,626	126%
Sedgwick	$4,626	126%
Cigna	$5,132 - $8,407	140%
Healthsmart	$7,564 - $10,457	207%
Midcoast	$7,668	210%
Quiktrip	$7,668	210%
University Of Mary Hardin-Baylor	$8,087	221%
Independent Medical System	$8,365	229%
Curative	$9,063	248%
First Health	$9,760	267%
Bluebell Creameries	$10,457	286%
Private Health Care System	$10,457	286%
Three Rivers	$12,548	343%

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 $8,365.
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 Baylor Scott & White Medical Center - Round Rock 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.