CMS Price Transparency Data

Inguinal hernia repair

Facility: Black River Memorial Hospital

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $430
Cash Discount Price: $4,524
vs. Medicare Baseline: 0.12x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at Black River Memorial Hospital is $430. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,524. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.12x the Medicare baseline. Located in 711 W Adams St, Black River Falls, WI.

Cash / Self-Pay

$4,524

Average discount available for prompt cash payment at this facility.

Insurance Median

$430

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: $4,524 (124%)

Insurance Median: $430 (12%)

Cash: $4,524 (124% of Medicare)

Ins. Median: $430 (12% 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	$77 - $477	2%
Group Health Cooperative Of Eau Claire	$77 - $4,876	2%
My Choice Wisconsin, Inc.	$77 - $430	2%
Quartz Health Solutions, Inc	$77 - $4,575	2%
UnitedHealthcare	$77 - $4,876	2%
Security Health Plan	$339 - $4,210	9%
The Alliance	$339 - $4,273	9%
Humana	$464 - $4,675	13%
Multiplan	$1,018 - $4,876	28%
Corvel	$3,066	84%
Triology Health Solutions	$4,524 - $4,776	124%
Medica	$4,695	128%
Association Benefits Solution	$4,776	131%
Family Health Center Of Marshfield	$4,776	131%
First Health Group Corporation	$4,776	131%
Provider Network Of America	$4,776	131%
Cigna	$4,876	133%
Cofinity	$4,876	133%
Coventry Health Care	$4,876	133%
Custom Benefit Administrators	$4,876	133%
Healthpartners, Inc.	$4,876	133%
Wisconsin Physicians Service Insurance Corp	$4,876	133%
Chorus	$4,926	135%

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 $4,524.
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 Black River Memorial 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.