CMS Price Transparency Data

Inguinal hernia repair

Facility: Texas Health Hospital Mansfield

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $11,871
Cash Discount Price: $10,992
vs. Medicare Baseline: 3.25x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at Texas Health Hospital Mansfield is $11,871. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $10,992. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 3.25x the Medicare baseline. Located in 2300 Lone Star Road, Mansfield, TX.

Cash / Self-Pay

$10,992

Average discount available for prompt cash payment at this facility.

Insurance Median

$11,871

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: $10,992 (300%)

Insurance Median: $11,871 (325%)

Cash: $10,992 (300% of Medicare)

Ins. Median: $11,871 (325% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 325% of the Medicare baseline (a markup of 225%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Amerigroup	$3,296	90%
Cigna	$3,362 - $31,018	92%
Blue_Cross_Blue_Shield	$3,461	95%
Molina	$3,461	95%
United_Healthcare	$3,461 - $11,871	95%
Wellcare	$3,626	99%
Blue_Cross_Blue_Shield_Of_Kansas	$6,903 - $37,240	189%
Aetna	$11,820 - $23,641	323%

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 $10,992.
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 Texas Health Hospital Mansfield 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.