Inguinal hernia repair
Facility: Kenmore Mercy Hospital
Billing Code: 49505 (CPT)
- CPT Billing Code: 49505
- Insurance Median: $478
- Cash Discount Price: $1,491
- 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 |
|---|---|---|
| UnitedHealthcare | $56 - $851 | 2% |
| Hospice [550001] | $68 - $748 | 2% |
| Seneca Nation [450119] | $68 - $748 | 2% |
| Cigna | $68 - $1,085 | 2% |
| VA Veterans Affairs [700001] | $68 - $673 | 2% |
| Fallon Health [450115] | $68 - $748 | 2% |
| Champ VA [700002] | $68 - $748 | 2% |
| Medicare (plans) | $68 - $823 | 2% |
| Tricare | $68 - $748 | 2% |
| Covid19 Hrsa [45013] | $68 - $748 | 2% |
| Univera Healthcare Essential [100170] | $69 - $645 | 2% |
| Univera Healthcare [100169] | $69 - $948 | 2% |
| Blue Cross Blue Shield | $74 - $912 | 2% |
| Medicaid / KanCare | $199 - $748 | 5% |
| Independent Health Essential [100166] | $199 - $351 | 5% |
| Amerigroup [350102] | $234 - $351 | 6% |
| Vna Option Mltc [350110] | $234 - $351 | 6% |
| Crime Victims [100176] | $234 - $351 | 6% |
| Excellus Rochester McD [350117] | $234 - $351 | 6% |
| Tuscarora Nation [550120] | $234 - $351 | 6% |
| Beacon Health Options [100023] | $424 - $898 | 12% |
| Beacon Essential [350122] | $424 - $898 | 12% |
| Humana | $449 - $786 | 12% |
| Wellcare [450129] | $466 - $823 | 13% |
| Fidelis Essential [100163] | $469 - $823 | 13% |
| Catholic Health Life Pace [400005] | $499 - $748 | 14% |
| Independent Health [100165] | $507 - $894 | 14% |
| Iha First Choice [800001] | $507 - $894 | 14% |
| Wellcare Fidelis Dual [450451] | $524 - $786 | 14% |
| Aetna | $524 - $786 | 14% |
| Fidelis Dual Advantage [450120] | $524 - $786 | 14% |
| Molina Essential [100167] | $526 - $789 | 14% |
| Mvp Healthcare [100168] | $545 - $962 | 15% |
| Ghi [100153] | $549 - $823 | 15% |
| Fidelis Exchange [100164] | $598 - $898 | 16% |
| UPMC Health Plan [100181] | $898 - $1,347 | 25% |
| No Fault [114001] | $1,136 - $1,704 | 31% |
| Federal Workers Compensation [500100] | $1,136 - $1,704 | 31% |