Inguinal hernia repair
Facility: Susan B Allen Memorial Hospital
Billing Code: 49505 (CPT)
- CPT Billing Code: 49505
- Insurance Median: $554
- Cash Discount Price: $5,565
- vs. Medicare Baseline: 0.15x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| UnitedHealthcare | $350 | 10% |
| Providrs Care | $757 | 21% |
Consumer Guidance & Cost Commentary
For an inguinal hernia repair at Susan B Allen Memorial Hospital in El Dorado, KS, the cash price is $5,565, which is significantly lower than the facility's gross charge of $8,561. While the hospital's negotiated rates with UnitedHealthcare and Providrs Care are $350 and $757 respectively, these amounts are far below the cash price, suggesting that for patients with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash price directly may result in lower total costs than relying on insurance reimbursement. It is important to note that commercial insurance rates often include administrative overhead and contract markups, making the cash price a more transparent baseline for comparison.
Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network emergency services at in-network facilities, unexpected charges can still occur if ancillary services are billed separately. If you receive a bill, always request a full itemized statement to verify that no services were unbundled or double-charged, as over 80% of hospital bills contain errors. Additionally, you should inquire about prompt-pay discounts before scheduling, as paying the cash price upfront can sometimes yield further reductions, and you should never sign away your rights to dispute out-of-network charges without fully understanding the terms.