Inguinal hernia repair
Facility: Centura St. Catherine-Dodge City
Billing Code: 49505 (CPT)
- CPT Billing Code: 49505
- Insurance Median: $468
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.13x 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 |
|---|---|---|
| Blue Cross Blue Shield | $468 | 13% |
| Cigna | $468 | 13% |
| Kansas Health | $468 | 13% |
| Humana | $468 | 13% |
| Medicare (plans) | $468 | 13% |
| Aetna | $468 | 13% |
| Kaiser | $468 | 13% |
Consumer Guidance & Cost Commentary
For the CPT code 49505 (Inguinal hernia repair) at Centura St. Catherine-Dodge City in Dodge City, KS, the negotiated rates across major payers like Blue Cross Blue Shield, Cigna, and Humana are consistently $468. This amount is significantly lower than the typical commercial markup often seen, as it aligns directly with the Medicare benchmark of $3,657.95. While commercial negotiated rates frequently range from 200% to 300% of Medicare, this facility's rate represents a fair pricing structure closer to the 120% to 150% range considered equitable. Patients should note that while cash-pay options are not listed in this report, asking the hospital for self-pay or prompt-pay discounts before scheduling can sometimes result in lower out-of-pocket costs, especially if your insurance deductible has not yet been met.
It is important to understand that the $468 figure represents the maximum allowed amount under contract, not the full chargemaster price. Under federal protections like the No Surprises Act, you should not be balance billed for out-of-network services at this in-network facility, though you may still receive itemized bills containing unbundled codes or services not rendered. If you receive a bill exceeding $468, you should request a formal itemized audit to identify errors such as double-billing or unnecessary charges before making a payment. Always verify your specific plan details with the hospital prior to your visit to ensure you are aware of any deductibles or copays that may apply to this negotiated rate.