CMS Price Transparency Data

Inguinal hernia repair

Facility: Providence Centralia Hospital

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $7,463
Cash Discount Price: $8,182
vs. Medicare Baseline: 2.04x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at Providence Centralia Hospital is $7,463. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8,182. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 2.04x the Medicare baseline. Located in 914 S Scheuber Road, Centralia, WA.

Cash / Self-Pay

$8,182

Average discount available for prompt cash payment at this facility.

Insurance Median

$7,463

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: $8,182 (224%)

Insurance Median: $7,463 (204%)

Cash: $8,182 (224% of Medicare)

Ins. Median: $7,463 (204% 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 204% of the Medicare baseline (a markup of 104%). 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
Kaiser	$4,146 - $15,502	113%
Aetna	$4,270 - $30,494	117%
UnitedHealthcare	$4,436	121%
Blue Shield	$4,478 - $25,367	122%
Amerigroup	$4,561	125%
Community Health Plan	$6,634	181%
Molina	$7,007	192%
Blue Cross Blue Shield	$7,463 - $21,118	204%
Coordinated Care	$7,670	210%
First Choice	$18,190	497%

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 $8,182.
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 Providence Centralia 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.