CMS Price Transparency Data

Inguinal hernia repair

Facility: Gundersen Lutheran Medical Center

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $3,312
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.91x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at Gundersen Lutheran Medical Center is $3,312. 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 0.91x the Medicare baseline. Located in 1910 South Ave, La Crosse, WI.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,312

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: $3,312 (91%)

Ins. Median: $3,312 (91% 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
Blue Cross Blue Shield	$1,576 - $11,611	43%
Group Health Eau Claire	$1,576	43%
Group Health Of South Central	$1,576	43%
Icare	$1,576 - $3,496	43%
Iowa Total Care	$1,576	43%
Managed Health Service	$1,576	43%
UnitedHealthcare	$1,576 - $3,496	43%
Health Partners	$3,296	90%
Ucare	$3,296 - $3,670	90%
Amerigroup	$3,312 - $3,496	91%
Molina Health	$3,312	91%
Aetna	$3,496	96%
Medical Associates	$3,496	96%

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 Gundersen Lutheran Medical Center 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.