CMS Price Transparency Data

Inguinal hernia repair

Facility: Baldwin Health

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $4,835
  • Cash Discount Price: $23,580
  • vs. Medicare Baseline: 1.32x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Baldwin Health is $4,835. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $23,580. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 1.32x the Medicare baseline. Located in 1613 North McKenzie Street, Foley, AL.
Cash / Self-Pay
$23,580

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,835

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: $23,580 (645%)
Insurance Median: $4,835 (132%)
Cash: $23,580 (645% of Medicare)
Ins. Median: $4,835 (132% 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%
Triwest $3,329 91%
Blue Cross Blue Shield $3,342 - $4,835 91%
Humana $3,342 91%
Medicare (plans) $3,342 91%
UnitedHealthcare $3,342 - $18,204 91%
Windsor Health Plan $3,342 91%
Community Hospice $3,397 93%
Hospice $3,397 93%
Mercy Medical Hospice $3,397 93%
Node Va $3,397 93%
Cigna $3,409 - $12,477 93%
Node Devoted Health Mcr Adv $3,409 93%
Node Clover Health Mcr Adv $3,431 94%
Select Health $3,431 94%
Aetna $3,442 - $117,902 94%
Node Wellcare Mcr Adv $3,464 95%
Us Dol $4,246 116%
Ambetter / Centene $5,095 139%
First Choice $5,502 150%
Tricare $14,093 385%
Node Champva $14,835 406%
Self Pay $23,580 645%
American Employee Alliance $52,401 1433%
Multiplan $74,671 - $107,422 2041%
First Health $98,252 - $105,785 2686%
Alamed $100,217 2740%
Multiplan Inc $100,217 2740%
Coventry Work Comp Al $102,444 2801%
One Health $104,802 2865%
Pro America $104,802 2865%
Novanet $105,785 2892%
Alabama Wc $111,352 3044%
Gulf Health $111,352 3044%
Principal Ppo $111,352 3044%
Viva Health $111,352 3044%
National Health $117,902 3223%
Galaxy $119,212 3259%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1613 North McKenzie Street, Foley, AL 36535
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals