CMS Price Transparency Data

Inguinal hernia repair

Facility: Alhambra Hospital Medical Center

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $6,218
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.70x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Alhambra Hospital Medical Center is $6,218. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 1.70x the Medicare baseline. Located in 100 S Raymond Ave, Alhambra, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$6,218

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%)
Insurance Median: $6,218 (170%)
Ins. Median: $6,218 (170% 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.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Citrus Valley Health Partners $344 9%
La Care Pasc Seiu Misc $344 9%
La Care Medi-Cal Hmo $396 11%
Allied Physicians Of Ca Medi-Cal $493 13%
Health Net Medi-Cal $493 13%
Kaiser Medi-Cal $493 13%
Medi-Cal $493 13%
Miscellaneous Medi-Cal Hmo $493 13%
Blue Cross Blue Shield $572 - $7,771 16%
Aetna $878 - $6,326 24%
Central Health Plan Of Ca Senior Hmo $1,518 41%
Molina Health Plan $2,336 64%
Ahmc-Reciprocity-Comm/Senior $4,605 126%
Ahmc-Reciprocity-Medi-Cal/Healthy Families $4,605 126%
Tricare $4,605 126%
Blue Shield Value Network Exchange $5,055 138%
Blue Shield Hmo/Ppo $5,635 154%
Blue Shield 65 Plus $5,969 163%
Apa Aco $6,124 167%
Miscellaneous Work Comp Hmo $6,125 167%
Altamed Senior Services $6,218 170%
Brand New Day Sr $6,218 170%
Health Net Senior Hmo $6,218 170%
Medicare (plans) $6,218 - $6,642 170%
Alignment Senior Hmo $6,326 173%
Allied Physicians Comm/Sr $6,326 173%
Humana $6,326 173%
La Care Exchange $6,326 173%
Miscellaneous Senior Hmo $6,326 173%
UnitedHealthcare $6,326 - $13,727 173%
Wellcare Senior Hmo $6,326 173%
Health Net Salud Con Hmo $7,692 210%
Molina Exchange $7,772 212%
Health Net Exchange $7,799 213%
Ahmc Health $9,326 255%
Allied Physicians Of Ca Commercial $9,488 259%
Health Net Ppo/Epo/Pos $13,189 361%
Health Net Exchange Enhanced Ppo $15,631 427%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 S Raymond Ave, Alhambra, CA 91801
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals