CMS Price Transparency Data

Inguinal hernia repair

Facility: Northwest Medical Center Sahuarita

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $3,859
  • Cash Discount Price: $18,146
  • vs. Medicare Baseline: 1.05x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Northwest Medical Center Sahuarita is $3,859. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $18,146. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 1.05x the Medicare baseline. Located in 16260 South Rancho Sahuarita Boulevard, Sahuarita, AZ.
Cash / Self-Pay
$18,146

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,859

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: $18,146 (496%)
Insurance Median: $3,859 (105%)
Cash: $18,146 (496% of Medicare)
Ins. Median: $3,859 (105% 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
Medicaid / KanCare $2,285 - $2,445 62%
Mercy Care $2,285 - $3,759 62%
Blue Cross Blue Shield $3,580 - $13,509 98%
Aetna $3,759 - $7,960 103%
Cigna $3,759 - $5,073 103%
Humana $3,759 103%
Medicare (plans) $3,759 103%
Node Caremore Mcr Adv $3,759 103%
Node Mercy Care Mcr Adv $3,759 103%
UnitedHealthcare $3,759 - $7,511 103%
Node Non Par Hospice Agree $3,821 104%
Node Triwest $3,821 - $4,092 104%
Node Va $3,821 104%
Node Clover Health Mcr Adv $3,859 105%
Node Devoted Health Mcr Adv $3,872 106%
Banner Mcr Adv $3,947 108%
Node Banner Mcr Adv $3,947 108%
Node Wellcare Mcr Adv $3,947 108%
Node Us Dept Of Labor $4,776 131%
Ambetter / Centene $5,387 147%
Node Health Choice Health Exchange $5,693 156%
Node Fusion Network $6,877 188%
Node J Allen Inmate Health Svcs $7,259 198%
Department Of Veterans Affairs $10,105 276%
Node Champva $10,105 276%
Tricare $10,105 276%
Self Pay $18,146 496%
Coventry Work Comp Al $60,488 1654%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 16260 South Rancho Sahuarita Boulevard, Sahuarita, AZ 85629
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals