CMS Price Transparency Data
Inguinal hernia repair
Facility: Uc San Diego Health Hillcrest - Hillcrest Med Ctr
Billing Code: 49505 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 49505
- Insurance Median: $14,672
- Cash Discount Price: $21,732
- vs. Medicare Baseline: 4.01x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Uc San Diego Health Hillcrest - Hillcrest Med Ctr is $14,672. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $21,732. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 4.01x the Medicare baseline. Located in 200 West Arbor Drive, San Diego, CA.
Cash / Self-Pay
$21,732
Average discount available for prompt cash payment at this facility.
Insurance Median
$14,672
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: $21,732 (594%)
Insurance Median: $14,672 (401%)
Cash: $21,732 (594% of Medicare)
Ins. Median: $14,672 (401% 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 401% of the Medicare baseline (a markup of 301%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 | $65 - $19,994 | 2% |
| Alternate Medi-Cal [2001] | $65 | 2% |
| Blue Cross Blue Shield | $65 - $23,171 | 2% |
| Brand New Day [1089] | $65 - $493 | 2% |
| Caremore [2028] | $65 | 2% |
| Community Eldercare [1027] | $65 | 2% |
| Medi-Cal [1048] | $65 | 2% |
| Vantage [1092] | $65 - $23,708 | 2% |
| Ximed [2016] | $65 | 2% |
| Alternate Molina [1240] | $82 | 2% |
| Molina [1055] | $82 - $4,484 | 2% |
| Community Health Group [1022] | $84 | 2% |
| Health Net [1039] | $88 - $25,684 | 2% |
| Alameda Alliance For Health [2027] | $493 | 13% |
| Alignment Health Plan [2020] | $493 | 13% |
| California Department Of Public Health [1237] | $493 | 13% |
| California Health & Wellness Medi-Cal [1122] | $493 | 13% |
| Cms - County Medical Services [1025] | $493 - $25,684 | 13% |
| Community Care Ipa [1131] | $493 | 13% |
| Federal Prison [1031] | $493 | 13% |
| Gold Coast Health Plan [2031] | $493 | 13% |
| Health Plan Of San Joaquin [2032] | $493 | 13% |
| Hemet Community Med Grp - Promisecare [1040] | $493 | 13% |
| Imperial Health Holdings [1132] | $493 | 13% |
| Kern Health Systems [2033] | $493 | 13% |
| La Care Health Plan [2025] | $493 | 13% |
| Medicaid / KanCare | $493 | 13% |
| Regal Mg 'Heritage Provider Network' [2019] | $493 | 13% |
| San Diego County [1071] | $493 - $19,757 | 13% |
| Sd Physicians Med Grp [1076] | $493 - $25,684 | 13% |
| State Of California [1082] | $493 | 13% |
| UnitedHealthcare | $493 - $27,659 | 13% |
| Unlisted Mcal Hmo Non-Contract [1049] | $493 | 13% |
| Champva [1020] | $552 | 15% |
| Mid County Physicians Med Grp [1054] | $552 | 15% |
| Inland Empire Health Plan Transplant [1126] | $691 | 19% |
| Inland Empire Health Plan [1121] | $691 | 19% |
| Cal Optima [1016] | $716 | 20% |
| Alternate Scan Health [2088] | $4,484 | 123% |
| Pace [2044] | $4,484 | 123% |
| San Diego Pace [2046] | $4,484 | 123% |
| Scan Health [1072] | $4,484 | 123% |
| Cigna | $4,742 - $23,708 | 130% |
| Humana | $4,742 - $33,586 | 130% |
| Mc Blue Shield Generic Payor [164016] | $4,742 | 130% |
| Mc Blue Shield Hmo [164015] | $4,742 | 130% |
| Mc Brand New Day Generic Payor [164031] | $4,742 | 130% |
| Mc Brand New Day Hmo [164030] | $4,742 | 130% |
| Mc Healthnet Generic Payor [164010] | $4,742 | 130% |
| Mc Healthnet Hmo [164004] | $4,742 | 130% |
| Mc Hnet Blue&Gold Aco [164017] | $4,742 | 130% |
| Mc Scan Generic Payor [164034] | $4,742 | 130% |
| Mc Scan Hmo [164035] | $4,742 | 130% |
| Uc Aff Blue Shield Sr/Sdsm [164037] | $4,742 | 130% |
| Padres Workers Compensation [2013] | $6,362 | 174% |
| Padres [2014] | $6,362 | 174% |
| Ucr Prompt Pay Payor [8240] | $8,021 | 219% |
| Blue Shield [1014] | $11,448 - $16,762 | 313% |
| Alternate Healthnet [1007] | $13,711 - $19,164 | 375% |
| Multicultural Med Grp [1057] | $14,343 | 392% |
| Alternate Blue Shield [2002] | $14,672 | 401% |
| Blue Shield Transplants [1113] | $14,672 | 401% |
| Elizabeth Hospice [2018] | $15,805 | 432% |
| Scripps Clinic [1073] | $15,805 - $23,708 | 432% |
| Blue Shield Promise [1017] | $17,781 | 486% |
| Alternate Health Net Bh [2059] | $19,164 | 524% |
| Healthnet Transplants [1114] | $19,164 | 524% |
| Usoc - Us Olympic Committee [1123] | $19,520 | 534% |
| Global Excel [1036] | $19,757 | 540% |
| Sharp Health Plan [1079] | $19,757 - $19,954 | 540% |
| Graybill Med Grp [1037] | $19,954 | 545% |
| Sharp Community Med Grp [1078] | $19,954 | 545% |
| Sharp Rees Stealy [1080] | $19,954 | 545% |
| Olympus Managed Healthcare Inc [1102] | $19,994 | 547% |
| Scripps Health Plan Services [1075] | $23,708 | 648% |
| Alternate Sheriff Custody [1106] | $25,684 | 702% |
| Arch Health Partners [2000] | $25,684 | 702% |
| Axa Assistance [1098] | $25,684 | 702% |
| Cassidy Med Grp [1019] | $25,684 | 702% |
| Cmn - Canadian Medical Network [1024] | $25,684 | 702% |
| Ets - Lifetrac Network [1103] | $25,684 | 702% |
| Health Net Bh (Mhn) [1038] | $25,684 | 702% |
| Health Net Bh (Mhn) [2010] | $25,684 | 702% |
| Interlink Health Services Transplant [1124] | $25,684 | 702% |
| Interlink Health Transplant [2085] | $25,684 | 702% |
| Mgm Resorts [1053] | $25,684 | 702% |
| National Healthcare Solutions Inc [1100] | $25,684 | 702% |
| Quality Health [1069] | $25,684 | 702% |
| San Diego County Sheriff Custody [2012] | $25,684 | 702% |
| Scripps Coastal Med Grp [1074] | $25,684 | 702% |
| Tri-City [1085] | $25,684 | 702% |
| Kaiser [1046] | $26,474 | 724% |
| Embassy Sponsored [1101] | $26,869 - $27,659 | 735% |
| Interplan [1045] | $27,659 | 756% |
| Mercy Physicians Med Grp [1052] | $27,659 | 756% |
| Pacific Foundation [1063] | $27,659 | 756% |
| Beech Street [1012] | $29,635 | 810% |
| First Health [1032] | $29,635 | 810% |
| Admar [1001] | $30,425 | 832% |
| Bps - Benefit Plan Services [1015] | $30,425 | 832% |
| Multiplan [1058] | $30,425 | 832% |
| Private Healthcare Systems [1067] | $30,425 - $39,513 | 832% |
| Carnival Cruises [1018] | $31,611 | 864% |
| Alternate Kaiser Rad Onc [2089] | $39,513 | 1080% |
| Sharp Healthcare Transplant [1119] | $53,343 | 1458% |