CMS Price Transparency Data

Inguinal hernia repair

Facility: Arbor Health Morton Hospital

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $505
Cash Discount Price: $944
vs. Medicare Baseline: 0.14x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at Arbor Health Morton Hospital is $505. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $944. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.14x the Medicare baseline. Located in 521 Adams Street, Morton, WA.

Cash / Self-Pay

$944

Average discount available for prompt cash payment at this facility.

Insurance Median

$505

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: $944 (26%)

Insurance Median: $505 (14%)

Cash: $944 (26% of Medicare)

Ins. Median: $505 (14% 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
Amerigroup-All Other Plans	$304	8%
Comm Health Healthy Options	$304	8%
Kaiser Mcaid	$304	8%
Molina Mcaid	$304	8%
UnitedHealthcare	$304 - $1,218	8%
Comm Health Basic Sub - All Other Plans	$365	10%
Aetna	$505 - $716	14%
Amerigroup Mcr Adv	$505	14%
Comm Health Mcr Adv	$505	14%
Healthnet Mcr Adv - All Plans	$505	14%
Humana	$505	14%
Mcr Railroad Mcr Adv - All Plans	$505	14%
Medicare (plans)	$505	14%
Premera Hmo Mcr Adv	$505	14%
Rural Health Mcare - All Plans	$505	14%
Regence Blue Shield Mcr Adv	$510	14%
Molina Mcr Adv	$530	14%
Wellcare Mcr Adv - All Plans	$530	14%
Comm Health Pebb	$547	15%
First Choice-All Plans	$721	20%
Kaiser Comm-All Other Plans	$728	20%
Molina Marketplace-All Other Plans	$914	25%
Regence Blue Shield Ump-All Other Plans	$1,066	29%
Premera First-All Other Plans	$1,371	37%
Cigna	$1,416	39%

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 $944.
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 Arbor Health Morton 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.