CMS Price Transparency Data

Inguinal hernia repair

Facility: Brattleboro Memorial Hospital

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $1,148
Cash Discount Price: $845
vs. Medicare Baseline: 0.31x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at Brattleboro Memorial Hospital is $1,148. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $845. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.31x the Medicare baseline. Located in 17 Belmont Ave, Brattleboro, VT.

Cash / Self-Pay

$845

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,148

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: $845 (23%)

Insurance Median: $1,148 (31%)

Cash: $845 (23% of Medicare)

Ins. Median: $1,148 (31% 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
Amerihealth-Caritas	$426 - $2,728	12%
New Hampshire Healthy Families	$426 - $2,728	12%
Wellsense	$426 - $3,622	12%
Blue Cross Blue Shield	$483 - $4,739	13%
Cigna	$483 - $3,487	13%
Harvard Pilgrim Health Care	$483 - $3,385	13%
Martin'S Point	$483 - $3,385	13%
Mvp Healthcare	$483 - $4,739	13%
New Hampshire Healthy Families (Wellcare)	$507 - $3,555	14%
Vermont Health Plan	$671	18%
Aetna	$1,066 - $1,277	29%
Coventry	$1,066 - $1,277	29%
Tufts Health Plan	$1,148	31%
Humana	$3,385	93%
UnitedHealthcare	$3,385	93%
Multiplan	$4,739	130%

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 $845.
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 Brattleboro Memorial 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.