CMS Price Transparency Data

Inguinal hernia repair

Facility: Oro Valley Hospital

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $4,362
  • Cash Discount Price: $13,740
  • vs. Medicare Baseline: 1.19x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Oro Valley Hospital is $4,362. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $13,740. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 1.19x the Medicare baseline. Located in 1551 East Tangerine Road, Oro Valley, AZ.
Cash / Self-Pay
$13,740

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,362

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: $13,740 (376%)
Insurance Median: $4,362 (119%)
Cash: $13,740 (376% of Medicare)
Ins. Median: $4,362 (119% 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 $501 14%
Medicaid / KanCare $2,285 - $2,445 62%
Magellan $2,399 - $34,350 66%
Blue Cross Blue Shield $3,580 - $8,759 98%
Aetna $3,759 - $10,877 103%
Caremore Health Plan $3,759 103%
Cigna $3,759 - $5,073 103%
Humana $3,759 103%
Medicare (plans) $3,759 103%
Scan Health $3,759 103%
UnitedHealthcare $3,759 - $7,511 103%
Pascua Yaqui Tribe $3,782 103%
Node Non Par Hospice Agree $3,821 104%
Node Triwest $3,821 104%
Node Va $3,821 104%
Fresenius Health $3,835 105%
Clover Health Mcr Adv $3,859 105%
Node Devoted Health Mcr Adv $3,872 106%
Node Banner Mcr Adv $3,947 108%
Wellcare Mcr Adv $3,947 108%
Node Us Dept Of Labor $4,776 131%
Ambetter / Centene $5,387 147%
Node Health Choice Exchange $5,693 156%
Department Of Veterans Affairs $5,945 163%
Tricare $5,945 163%
Node Fusion Network $6,877 188%
Node J Allen Inmate Health Svcs $7,259 198%
Health Net $8,023 219%
Seven Corners $8,787 240%
Self Pay $13,740 376%
Beacon Health Options $28,625 783%
Mtc $28,625 783%
First Health Coventry $30,056 822%
Coventry Work Comp Al $34,350 939%
Multiplan $47,517 1299%
Prime Health $48,662 1330%
Three Rivers $48,662 1330%
Healthsmart $51,524 1409%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1551 East Tangerine Road, Oro Valley, AZ 85755
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals