CMS Price Transparency Data

Inguinal hernia repair

Facility: Gadsden Regional Medical Center

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $3,934
  • Cash Discount Price: $14,816
  • vs. Medicare Baseline: 1.08x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Gadsden Regional Medical Center is $3,934. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $14,816. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 1.08x the Medicare baseline. Located in 1007 Goodyear Avenue, Gadsden, AL.
Cash / Self-Pay
$14,816

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,934

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: $14,816 (405%)
Insurance Median: $3,934 (108%)
Cash: $14,816 (405% of Medicare)
Ins. Median: $3,934 (108% 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
Veterans Eval Services $463 13%
Medicaid / KanCare $542 15%
Blue Cross Blue Shield $3,160 86%
Humana $3,160 86%
Medicare (plans) $3,160 86%
Node Viva Mcr Adv $3,160 86%
Node Select Health Mcr Adv $3,192 87%
Amedisys Hospice $3,211 88%
Gadsden Hospice $3,211 88%
Node Non Par Hospice Agree $3,211 88%
Node Va $3,211 88%
Southern Care Hospice $3,211 88%
UnitedHealthcare $3,211 - $9,921 88%
Cigna $3,223 - $18,974 88%
Node Devoted Health Mcr Adv $3,223 88%
Node Clover Health Mcr Adv $3,243 89%
Aetna $3,254 - $63,956 89%
Node Wellcare Mcr Adv $3,276 90%
Node Eon Mcr Adv $3,318 91%
Prime Health $3,381 - $89,206 92%
Viva Healthcare $3,900 107%
Node Us Dept Of Labor $4,014 110%
Ambetter / Centene $4,817 132%
Tricare $13,291 363%
Node Champva $13,991 382%
Self Pay $14,816 405%
American Employee Alliance $49,387 1350%
Multiplan $70,377 - $77,785 1924%
Magellan Behavioral $74,081 2025%
First Health $86,428 - $99,700 2363%
Beech Street $90,132 2464%
Alamed Wc $92,601 2531%
Focus Health $94,453 2582%
Coventry Work Comp Al $96,552 2640%
Work Comp $104,948 2869%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1007 Goodyear Avenue, Gadsden, AL 35903
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals