CMS Price Transparency Data
Inguinal hernia repair
Facility: Clovis Community Medical Center
Billing Code: 49505 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 49505
- Insurance Median: $516
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.14x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Clovis Community Medical Center is $516. 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 0.14x the Medicare baseline. Located in 2755 Herndon Ave, Clovis, CA.
Cash / Self-Pay
Unavailable
Average discount available for prompt cash payment at this facility.
Insurance Median
$516
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: $516 (14%)
Ins. Median: $516 (14% 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
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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 |
|---|---|---|
| Blue Cross Blue Shield | $65 - $7,078 | 2% |
| Blue Shield | $344 - $6,637 | 9% |
| Cal Caloptima | $344 | 9% |
| Ccs Fresno | $344 | 9% |
| Ccs Kern | $344 | 9% |
| Ccs Kings | $344 | 9% |
| Ccs Madera/Sacramento | $344 | 9% |
| Ccs Mariposa | $344 | 9% |
| Ccs Merced | $344 | 9% |
| Ccs Stanislaus | $344 | 9% |
| Ccs Tulare | $344 | 9% |
| Chdp | $344 | 9% |
| Fresno County Funded Specialty Care | $344 | 9% |
| Generic Care Out Of County | $344 | 9% |
| Generic Ccs Other Counties | $344 | 9% |
| Genetically Handicapped Person | $344 | 9% |
| Gold Coast Medi-Cal | $344 | 9% |
| Medi-Cal Alameda Alliance For Health | $344 | 9% |
| Medi-Cal Blue Shield Promise Health | $344 | 9% |
| Medi-Cal California Health & Wellness Plan | $344 | 9% |
| Medi-Cal Cencal Health | $344 | 9% |
| Medi-Cal Community Health Group | $344 | 9% |
| Medi-Cal Contra Costa Health Plan | $344 | 9% |
| Medi-Cal Health Plan Of San Mateo | $344 | 9% |
| Medi-Cal Inland Empire Health | $344 | 9% |
| Medi-Cal Kern Family Health | $344 | 9% |
| Medi-Cal La Care Health | $344 | 9% |
| Medi-Cal Molina | $344 | 9% |
| Medi-Cal Partnership Health Plan Of Ca | $344 | 9% |
| San Francisco Health Plan Medi-Cal | $344 | 9% |
| Santa Clara Family Health Plan - Premier Health | $344 | 9% |
| Santa Clara Family Health Plan - Valley Health | $344 | 9% |
| Advantek Table Mountain Rancheria Tribal Member | $498 - $4,605 | 14% |
| Aetna | $498 - $5,784 | 14% |
| Blue Shield 65 Plus Hmo Ehs | $498 - $4,605 | 14% |
| Blue Shield 65 Plus Hmo First Choice | $498 - $4,605 | 14% |
| Blue Shield Hmo-Cvmp/Medpro | $498 - $4,605 | 14% |
| Blue Shield Promise - Imperial | $498 - $4,605 | 14% |
| Blue Shield Saint Agnes | $498 - $4,605 | 14% |
| Blue Shield Sante | $498 - $4,605 | 14% |
| Brand New Day | $498 - $4,605 | 14% |
| Bscphp - Dhmso | $498 - $4,605 | 14% |
| Bscphp - First Choice | $498 - $4,605 | 14% |
| Bscphp Hmo - First Choice | $498 - $4,605 | 14% |
| Care1St Hmo - Ehs | $498 - $4,605 | 14% |
| Cares Act Provider Relief Fund | $498 - $4,605 | 14% |
| Cigna | $498 - $8,198 | 14% |
| Gemcare Hmo | $498 - $4,605 | 14% |
| Generic | $498 - $4,605 | 14% |
| Generic Bscphp | $498 - $4,605 | 14% |
| Generic Victims Of Crime | $498 - $4,605 | 14% |
| Hartford Life Supplement | $498 - $4,605 | 14% |
| Healthnet Hmo - Cvmp/Medpro | $498 - $4,605 | 14% |
| Healthnet Hmo - Dhmso | $498 - $4,605 | 14% |
| Healthnet Hmo - La Salle | $498 - $4,605 | 14% |
| Healthnet Hmo - Sante | $498 - $4,605 | 14% |
| Healthnet Sante | $498 - $4,605 | 14% |
| Healthnet Sante - Sub Cap Dual Risk | $498 - $4,605 | 14% |
| Healthnet Sante Dual Risk | $498 - $4,605 | 14% |
| Humana | $498 - $4,605 | 14% |
| Medi-Cal Innovative Integrated Health | $498 - $4,605 | 14% |
| Medicare (plans) | $498 - $4,605 | 14% |
| Meritage Blue Shield 65 Plus | $498 - $4,605 | 14% |
| Meritage Brand New Day | $498 - $4,605 | 14% |
| Meritage Healthnet Hmo | $498 - $4,605 | 14% |
| Railroad Part A | $498 - $4,605 | 14% |
| Railroad Part A & B | $498 - $4,605 | 14% |
| Railroad Part B | $498 - $4,605 | 14% |
| Sante | $498 - $4,605 | 14% |
| Sante Sub Cap Healthnet Seniority | $498 - $4,605 | 14% |
| Sante Sub Cap-Blue Shield/Sante | $498 - $4,605 | 14% |
| Sante-Blue Shield/Sante | $498 - $4,605 | 14% |
| Sante-Healthnet Seniority | $498 - $4,605 | 14% |
| Sante-Sub Cap Ma Brand New Day | $498 - $4,605 | 14% |
| Scan Health Plan | $498 - $4,605 | 14% |
| Sequoia Pace - Peak Tpa | $498 - $4,605 | 14% |
| Todays Pyramid | $498 - $4,605 | 14% |
| UnitedHealthcare | $498 - $8,367 | 14% |
| Us Marshal | $498 - $4,605 | 14% |
| Victims Of Crime | $498 - $4,605 | 14% |
| Well Path (Cfmg) | $498 | 14% |
| Wellcare | $498 - $4,605 | 14% |
| Health Plan Of San Joaquin | $516 | 14% |
| Sequoia Pace | $516 | 14% |
| Alignment Health Plan | $548 - $5,065 | 15% |
| Champion Health Plan Of California Ma | $548 - $5,065 | 15% |
| Innovative Integrated Health Community Plans Hmo | $548 - $5,065 | 15% |
| Adventist -Mcl Calviva Sub Cap | $568 | 16% |
| Imperial Health Plan Hmo | $573 - $5,296 | 16% |
| Correctcare Integrated Health | $647 - $5,986 | 18% |
| Healthnet | $662 | 18% |
| Coalinga State Hospital | $996 - $9,210 | 27% |
| Naphcare Inc-Mendota | $1,071 - $9,901 | 29% |
| Kaiser | $3,658 | 100% |
| Generic Multiplan | $8,490 | 232% |
| Phcs | $8,490 | 232% |