CMS Price Transparency Data

Inguinal hernia repair

Facility: Mary Bridge Children's Hospital

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $4,312
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.18x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at Mary Bridge Children's Hospital is $4,312. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 1.18x the Medicare baseline. Located in 317 Martin Luther King Jr W Box 5299, Tacoma, WA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,312

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%)

Insurance Median: $4,312 (118%)

Ins. Median: $4,312 (118% 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
Molina	$2,475 - $7,252	68%
Community Health Plan Of Washington	$2,673 - $7,796	73%
Coordinated Care	$2,673	73%
UnitedHealthcare	$2,673 - $4,077	73%
Wellpoint	$2,673	73%
Aetna	$4,038 - $24,142	110%
Regence	$4,038 - $18,755	110%
Wellcare	$4,116	113%
Premera	$6,221 - $15,885	170%
Ambetter / Centene	$8,786	240%
Kaiser	$26,194	716%

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 $X.
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 Mary Bridge Children's 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.