CMS Price Transparency Data

Inguinal hernia repair

Facility: Menifee Global Medical Center

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $7,770
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 2.12x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Menifee Global Medical Center is $7,770. 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 2.12x the Medicare baseline. Located in 28400 McCall Boulevard, Sun City, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$7,770

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: $7,770 (212%)
Ins. Median: $7,770 (212% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 212% of the Medicare baseline (a markup of 112%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Lasalle Medical Assoc (Ancillary) Mcal Hmo $406 11%
Health Net Medi-Cal $493 13%
Ic $493 - $7,770 13%
Kaiser Medi-Cal $493 13%
Prospect Health Plan Mcal Hmo $508 14%
Blue Cross Blue Shield $518 14%
Molina Medi-Cal $582 16%
Tricare $663 - $7,496 18%
Altamed Mcal Hmo $691 19%
Altamed Mcal/Pace $691 19%
Iehp Medi-Cal $740 20%
Health Net Enhanced Ppo $1,092 - $10,878 30%
Cigna $3,681 101%
Choice Physicians Network $5,200 142%
Molina Covered Ca $7,324 200%
Aetna $7,770 212%
Altamed Comm Hmo (Ancillary) $7,770 212%
Altamed Health Services Senior $7,770 212%
Altamed Sr/Pace $7,770 212%
Blue Shield Senior $7,770 212%
Central Health Plan Senior $7,770 212%
Clever Care Health Plan Sr $7,770 212%
For Your Benefit Senior $7,770 212%
Guidant Health Plan Senior $7,770 212%
Health Net Senior $7,770 212%
Hpn Senior $7,770 212%
Humana $7,770 212%
Kaiser Senior $7,770 212%
Lasalle Medical Assoc (Ancillary) Senior $7,770 212%
Managed Health Network Sr $7,770 212%
Medicare (plans) $7,770 212%
Neighborhood Healthcare Pace $7,770 212%
Primecare Senior $7,770 212%
Prospect Health Plan Sr Hmo $7,770 212%
Scan Senior $7,770 212%
Sr Capitation $7,770 212%
UnitedHealthcare $7,770 - $9,285 212%
Veterans Administration $7,770 212%
Imperial Health Plan Of Ca $7,808 213%
Lasalle Medical Assoc (Ancillary) Commercial $7,808 213%
Point Comfort Underwriters $7,808 213%
Self Pay/Ab774/Charity Discount $7,808 213%
Align Senior Care $8,702 238%
Welbehealth Sr/Pace $8,702 238%
Prime Health Services Senior $8,935 244%
Coventry $9,346 - $9,710 255%
Prime Health Services Wcomp $9,346 255%
Iehp Covered Ca $9,712 266%
Three Rivers Wcomp $10,177 278%
Workers Comp Non-Contracted $10,385 284%
Prospect Health Plan Comm Hmo $10,489 287%
Hpn Commercial/Covered Ca $10,878 297%
Health Net Comm $11,655 319%
Three Rivers Network $13,664 374%
Velocity $13,664 374%
Blue Shield Epn $21,834 597%
Blue Shield Commercial $25,718 703%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 28400 McCall Boulevard, Sun City, CA 92585
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals