CMS Price Transparency Data

Inguinal hernia repair

Facility: Uva Health Culpeper Medical Center

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $6,091
Cash Discount Price: $13,183
vs. Medicare Baseline: 1.67x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at Uva Health Culpeper Medical Center is $6,091. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $13,183. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 1.67x the Medicare baseline. Located in 501 Sunset Lane, Culpeper, VA.

Cash / Self-Pay

$13,183

Average discount available for prompt cash payment at this facility.

Insurance Median

$6,091

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: $13,183 (360%)

Insurance Median: $6,091 (167%)

Cash: $13,183 (360% of Medicare)

Ins. Median: $6,091 (167% 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
Champva [50002]	$522 - $532	14%
Tricare	$522 - $532	14%
Aetna	$1,538 - $6,344	42%
Cigna	$3,172 - $10,169	87%
Blue Ridge Pace [10510]	$3,233 - $5,482	88%
Medicaid / KanCare	$3,233 - $5,482	88%
Blue Cross Blue Shield	$3,592 - $19,422	98%
HMO Part B [10099]	$3,592 - $6,091	98%
Humana	$3,592 - $6,407	98%
Medicare (plans)	$3,592 - $6,281	98%
UnitedHealthcare	$3,592 - $24,734	98%
VA Ccn [99926]	$3,592 - $6,281	98%
VA Ccn [99927]	$3,592 - $6,281	98%
Veterans Administration [99910]	$3,704 - $6,281	101%
Carefirst [30007]	$4,446 - $5,036	122%
Geha [40009]	$6,303 - $17,321	172%

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 $13,183.
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 Uva Health Culpeper Medical Center 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.