CMS Price Transparency Data

Inguinal hernia repair

Facility: Memorialcare Orange Coast Medical Center

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $7,113
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.94x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at Memorialcare Orange Coast Medical Center is $7,113. 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 1.94x the Medicare baseline. Located in 9920 Talbert Avenue, Fountain Valley, CA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$7,113

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: $7,113 (194%)

Ins. Median: $7,113 (194% 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
Heritage Provider Network	$2,061	56%
Aetna	$2,609 - $4,487	71%
Cigna	$3,720 - $5,848	102%
Seoul Medical Group	$4,144	113%
Blue Shield	$4,513 - $10,069	123%
Blue Cross Blue Shield	$4,605 - $12,575	126%
Molina	$4,743	130%
Universal Care	$4,835	132%
Central Health	$5,065	138%
Clever Care	$5,526	151%
Healthcare Partners	$5,756 - $12,526	157%
Select Health	$6,217	170%
Monarch Health Plan	$7,414 - $11,512	203%
Healthnet	$10,220 - $14,600	279%
UnitedHealthcare	$10,295 - $18,287	281%
Centivo	$10,361	283%

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 $X.
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 Memorialcare Orange Coast 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.