CMS Price Transparency Data

Inguinal hernia repair

Facility: Medical Center Enterprise

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $3,275
  • Cash Discount Price: $8,802
  • vs. Medicare Baseline: 0.90x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Medical Center Enterprise is $3,275. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8,802. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.90x the Medicare baseline. Located in 400 N Edwards Street, Enterprise, AL.
Cash / Self-Pay
$8,802

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,275

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: $8,802 (241%)
Insurance Median: $3,275 (90%)
Cash: $8,802 (241% of Medicare)
Ins. Median: $3,275 (90% 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
Al Maternity Waiver Program $411 11%
Veterans Eval Services $463 13%
Medicaid / KanCare $542 - $2,479 15%
Blue Cross Blue Shield $3,036 - $4,625 83%
Humana $3,036 83%
Medicare (plans) $3,036 83%
UnitedHealthcare $3,036 - $5,251 83%
Select Health $3,067 84%
Covenant Hospice $3,086 84%
Dayspring Hospice $3,086 84%
Node Hospice Non Par $3,086 84%
Node Va $3,086 84%
Southerncare Hospice $3,086 84%
Healthspring $3,097 85%
Node Devoted Health Mcr Adv $3,097 85%
Node Clover Mcr Adv $3,117 85%
Aetna $3,127 - $68,457 85%
Node Wellcare Mcr Adv $3,147 86%
Eon Health $3,188 87%
Wiregrass Hospice $3,275 90%
Node Us Dept Of Labor $3,857 105%
Ambetter / Centene $4,629 127%
Cigna $5,052 - $32,715 138%
Occunet $5,400 148%
Self Pay $8,802 241%
Tricare $14,860 406%
Node Champva $15,642 428%
American Employee Alliance $39,118 1069%
Alamed $58,678 1604%
City Of Enterprise $58,678 1604%
Affordable Health $68,457 1871%
Health Choice $68,457 1871%
Novanet Ppo $68,457 1871%
Coventry Work Comp Al $71,978 1968%
Multiplan $72,369 - $75,303 1978%
Wc Dept Ind Relations $78,237 2139%
Corvel $83,126 2272%
Galaxy Health $88,016 2406%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 400 N Edwards Street, Enterprise, AL 36330
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals