CMS Price Transparency Data

Inguinal hernia repair

Facility: Lake Chelan Community Hospital

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $10,506
Cash Discount Price: $10,636
vs. Medicare Baseline: 2.87x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at Lake Chelan Community Hospital is $10,506. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $10,636. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 2.87x the Medicare baseline. Located in 110 S Apple Blossom Dr, Chelan, WA.

Cash / Self-Pay

$10,636

Average discount available for prompt cash payment at this facility.

Insurance Median

$10,506

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: $10,636 (291%)

Insurance Median: $10,506 (287%)

Cash: $10,636 (291% of Medicare)

Ins. Median: $10,506 (287% 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 287% of the Medicare baseline (a markup of 187%). 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 Op Only - All Plans	$304 - $11,161	8%
Coordinated Care Mcaid	$304 - $11,161	8%
UnitedHealthcare	$304 - $17,764	8%
Medicare (plans)	$505 - $10,506	14%
Molina - All Plans	$505 - $17,650	14%
Coordinated Care Comm - All Other Plans	$656 - $18,750	18%
Premera First - All Plans	$709 - $14,326	19%
First Choice - All Plans	$716 - $18,146	20%
Aetna	$1,953 - $17,191	53%
Corvel - All Plans	$2,061 - $18,146	56%
Multiplan - All Plans	$17,000	465%

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 $10,636.
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 Lake Chelan Community 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.