CMS Price Transparency Data

Inguinal hernia repair

Facility: Oroville Hospital

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $1,790
Cash Discount Price: $933
vs. Medicare Baseline: 0.49x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at Oroville Hospital is $1,790. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $933. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.49x the Medicare baseline. Located in 2767 Olive Highway, Oroville, CA.

Cash / Self-Pay

$933

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,790

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: $933 (26%)

Insurance Median: $1,790 (49%)

Cash: $933 (26% of Medicare)

Ins. Median: $1,790 (49% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Blue Cross Blue Shield	$403 - $2,462	11%
Butte County	$520 - $779	14%
Cigna	$1,194 - $1,790	33%
Coventry Health Care	$1,194 - $1,790	33%
Health Net	$1,194 - $1,790	33%
Multiplan	$1,194 - $1,790	33%
Interplan	$1,268 - $1,902	35%
Three Rivers Provider Network	$1,268 - $1,902	35%
UnitedHealthcare	$1,268 - $3,296	35%
Beech Street	$1,343 - $2,014	37%
Healthstar	$1,343 - $2,014	37%
Health Payors Organization	$1,417 - $2,126	39%
Blue Shield Of California	$1,447 - $2,171	40%
Aetna	$3,296	90%
Community Care	$3,296	90%
Nivano Physicians Inc	$3,296	90%
River City Medical Group	$3,626	99%
Blue Shield Value Network	$4,374	120%
Partnership Healthplan Of California	$5,439	149%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $933.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 49505.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Oroville Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 49505.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.