CMS Price Transparency Data

Inguinal hernia repair

Facility: Southeast Health Medical Center

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $5,313
  • Cash Discount Price: $9,533
  • vs. Medicare Baseline: 1.45x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Southeast Health Medical Center is $5,313. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $9,533. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 1.45x the Medicare baseline. Located in 1108 Ross Clark Circle, Dothan, AL.
Cash / Self-Pay
$9,533

Average discount available for prompt cash payment at this facility.

Insurance Median
$5,313

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: $9,533 (261%)
Insurance Median: $5,313 (145%)
Cash: $9,533 (261% of Medicare)
Ins. Median: $5,313 (145% 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.

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
Humana $1,015 - $5,820 28%
UnitedHealthcare $3,054 - $5,820 83%
Aetna $3,432 - $5,820 94%
Blue Cross Blue Shield $3,432 - $5,820 94%
Care Improvement Plus $3,432 - $5,820 94%
Cigna $3,432 - $5,820 94%
Security Health $3,432 - $5,820 94%
Simpra Advantage $3,432 - $5,820 94%
Viva Health $3,432 - $5,820 94%
Wellcare $3,432 - $5,820 94%
Ambetter / Centene $4,634 - $7,857 127%
Direct Connect Contracting $4,805 - $8,148 131%
Naphcare $6,350 - $10,767 174%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1108 Ross Clark Circle, Dothan, AL 36301
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals