CMS Price Transparency Data

Inguinal hernia repair

Facility: Paradise Valley Hospital

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $4,582
  • Cash Discount Price: $4,582
  • vs. Medicare Baseline: 1.25x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Paradise Valley Hospital is $4,582. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,582. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 1.25x the Medicare baseline. Located in 2400 East 4Th St, National City, CA.
Cash / Self-Pay
$4,582

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,582

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: $4,582 (125%)
Insurance Median: $4,582 (125%)
Cash: $4,582 (125% of Medicare)
Ins. Median: $4,582 (125% 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
Aetna $493 - $5,855 13%
Blue Sheid Of Promise $493 13%
County Of San Diego $493 13%
Golden Physicians Medical Group $493 - $5,728 13%
Health Excel Ins $493 - $4,582 13%
Heritage Provider Netwrok $493 - $5,957 13%
Molina $493 - $4,582 13%
Traditional Medi-Cal $493 13%
UnitedHealthcare $493 - $4,582 13%
Health Net Of Ca $528 - $6,690 14%
Community Health Group $592 - $4,582 16%
Blue Shield Of Ca, Va $4,582 125%
Ca Foundation For Medical Care $4,582 125%
Central Health $4,582 125%
Choice Physicians Network $4,582 125%
Clever Care Of Golden State, Inc $4,582 125%
Managed Health Network $4,582 125%
Medicare (plans) $4,582 125%
Renal Payer Solutions $4,582 125%
Tricare $4,582 125%
Usa Senior Care Network $4,582 125%
Verda Health Plan $4,582 125%
Brand New Day $4,628 - $6,874 127%
Imperial Health Plan Of Ca $4,857 133%
Health Net Federal Service (Cdcr) $5,728 157%
Veterans Evaluation Services $5,728 157%
Worker Comp $6,037 165%
Integrated Medical Solutions $6,049 165%
Ca Dept Of Correction & Rehab $6,415 175%
Employer Direct Healthcare $6,415 175%
Naphcare $7,103 - $9,165 194%
Scripps Health $7,790 213%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2400 East 4Th St, National City, CA 91950
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals