CMS Price Transparency Data

Inguinal hernia repair

Facility: Flowers Hospital

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $3,674
  • Cash Discount Price: $6,858
  • vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Flowers Hospital is $3,674. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,858. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 1.00x the Medicare baseline. Located in 4370 West Main Street, Dothan, AL.
Cash / Self-Pay
$6,858

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,674

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: $6,858 (187%)
Insurance Median: $3,674 (100%)
Cash: $6,858 (187% of Medicare)
Ins. Median: $3,674 (100% 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%
Alabama Rehab $542 15%
Medicaid / KanCare $542 - $2,479 15%
Cigna $2,641 - $3,462 72%
Blue Cross Blue Shield $3,394 - $5,128 93%
Humana $3,394 93%
Medicare (plans) $3,394 93%
Node Viva Mcr Adv $3,394 93%
UnitedHealthcare $3,394 - $7,164 93%
Select Health $3,428 94%
Compassionate Hands $3,449 94%
Covenant Hospice $3,449 94%
Dayspring Hospice $3,449 94%
Node Hospice Non Par $3,449 94%
Node Va $3,449 94%
Southern Care Hospice $3,449 94%
Vistacare Hospice $3,449 94%
Wiregrass Hospice $3,449 94%
Care Improvement Plus $3,462 95%
Node Devoted Health Mcr Adv $3,462 95%
Node Clover Health Mcr Adv $3,484 95%
Aetna $3,495 - $33,375 96%
Choicecare Commercial $3,500 96%
Node Wellcare Mcr Adv $3,518 96%
Eon Health Care $3,564 97%
Prime Health $3,632 - $32,255 99%
Node Us Dept Of Labor $4,312 118%
Ambetter / Centene $5,174 141%
Tricare $5,187 142%
Viva Health $5,219 143%
Node Champva $5,460 149%
Multiplan $5,578 - $36,576 152%
Occunet $6,036 165%
Self Pay $6,858 187%
S & S Healthcare $11,430 312%
American Employee Alliance $18,288 500%
Coventry Healthcare $22,860 - $34,911 625%
Standard Textile $32,004 875%
Alamed Wc $32,255 882%
Health Choice $33,375 912%
Equian $34,290 - $36,050 937%
Qhp $34,290 937%
Novanet $36,576 1000%
Alabama Work Comp $37,947 1037%
Ccn/Mednet Ppo $38,862 1062%
Corvel $38,862 1062%
Industry Buying Group $38,862 1062%
Galaxy Health $41,148 1125%
Health Payors Org $41,148 1125%
National Provider Net $41,148 1125%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4370 West Main Street, Dothan, AL 36302
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals