CMS Price Transparency Data

Inguinal hernia repair

Facility: Saint Francis Medical Center

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 Saint Francis Medical Center 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 3630 East Imperial Highway, Lynwood, 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.

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
Aids Healthcare Foundation	$493 - $4,674	13%
Avanti Hospitals, Llc	$493 - $4,582	13%
Health Net Of Ca	$493 - $5,957	13%
Heritage Provider Network	$493	13%
Kaiser Hospital Foundation	$493 - $4,582	13%
La Care Health Plan	$493 - $5,499	13%
Molina	$493 - $4,582	13%
Traditional Medi-Cal	$493	13%
Blue Shield Of Promise	$518 - $4,582	14%
Blue Cross Blue Shield	$543	15%
Alignment	$4,582	125%
Altamed	$4,582	125%
Blue Shield Of Ca, Va	$4,582	125%
Elite Health Plan	$4,582	125%
Medicare (plans)	$4,582	125%
Renal Payer Solutions	$4,582	125%
Tricare	$4,582	125%
UnitedHealthcare	$4,582	125%
Welbe Health Pace	$4,582	125%
Brand New Day	$4,628 - $6,874	127%
Imperial Health Plan Of Ca	$4,857	133%
Coventry Healthcare Wc, Inc.	$5,856	160%
Multiplan	$5,856	160%
Worker Comp	$6,037	165%
Aetna	$6,874	188%

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 $4,582.
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 Saint Francis Medical Center 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.