CMS Price Transparency Data
Inguinal hernia repair
Facility: Whittier Hospital Medical Center
Billing Code: 49505 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 49505
- Insurance Median: $4,531
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.24x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Whittier Hospital Medical Center is $4,531. 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 1.24x the Medicare baseline. Located in 9080 Colima Rd, Whittier, CA.
Cash / Self-Pay
Unavailable
Average discount available for prompt cash payment at this facility.
Insurance Median
$4,531
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: $4,531 (124%)
Ins. Median: $4,531 (124% 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 |
|---|---|---|
| Aids Healthcare Foundation | $344 - $4,531 | 9% |
| Allied Physicians | $344 - $6,907 | 9% |
| Alta Med Health Network | $344 - $4,531 | 9% |
| Altamed Health Services Corporation | $344 | 9% |
| Beverly Hospital | $344 - $5,065 | 9% |
| Brand New Day | $344 - $5,664 | 9% |
| Emanate Health | $344 - $5,660 | 9% |
| Health Net | $344 - $4,531 | 9% |
| Healthy Way La | $344 | 9% |
| Heritage Provider Network | $344 - $6,217 | 9% |
| Kaiser Foundation | $344 - $16,117 | 9% |
| La Care Healthy Families/Healthy Kids | $344 | 9% |
| Non Contracted Medi-Cal | $344 | 9% |
| Prospect Health Plan | $344 - $7,368 | 9% |
| Synermed | $344 - $4,605 | 9% |
| La Care Health Plan | $396 - $4,531 | 11% |
| Caloptima | $482 - $4,531 | 13% |
| Monarch Healthplan | $482 | 13% |
| Care First Health Plan | $493 | 13% |
| County Of Los Angeles Dept Of Health Services | $493 | 13% |
| Medi Caid/ Medi Cal | $493 | 13% |
| Applecare Medical Group | $634 | 17% |
| Central Health Plan Of California | $674 | 18% |
| Aetna | $810 - $6,570 | 22% |
| Medicare (plans) | $897 - $4,757 | 25% |
| Universal Care | $1,050 - $1,100 | 29% |
| Health Net Inc | $1,070 - $11,830 | 29% |
| Pacific Independent Physician Association | $1,400 | 38% |
| UnitedHealthcare | $1,968 - $10,395 | 54% |
| Capnet | $2,000 | 55% |
| Edward Medical Group | $2,000 | 55% |
| Molina Medical Center | $2,284 - $5,756 | 62% |
| Great-West Healthcare Of California | $2,500 | 68% |
| Prohealth | $2,500 | 68% |
| Care 1St Health Plan | $2,600 - $5,500 | 71% |
| Alignment Health Plan | $2,613 | 71% |
| Cost Containment | $2,800 | 77% |
| Veterans Administration | $3,223 | 88% |
| Blue Cross Blue Shield | $3,595 - $9,363 | 98% |
| Avanti | $4,144 - $5,526 | 113% |
| Hollywood Presbyterian Adv Med Mcal | $4,144 | 113% |
| Hollywood Presbyterian Medpoint Mcal | $4,144 | 113% |
| Ahmc Reciprocity | $4,531 - $4,605 | 124% |
| Alta Los Angeles Hospitals Inc | $4,531 | 124% |
| Apa/Aco Inc | $4,531 | 124% |
| Central Health Plan | $4,531 | 124% |
| Easy Choice Health Plan | $4,531 | 124% |
| Humana | $4,531 | 124% |
| Pacificare Of California | $4,531 | 124% |
| Scan Health Plan | $4,531 | 124% |
| Ahmc Medi-Cal Reciprocity Agreement | $4,605 | 126% |
| Ahmc Reciprocity Agreement Senior/Commercial | $4,605 | 126% |
| Blue Shield Of California | $4,605 - $5,531 | 126% |
| Caremore | $4,605 | 126% |
| Cov19 Hrsa Uninsured Testing And Treatment Fund | $4,605 | 126% |
| La Care Covered Direct | $4,605 | 126% |
| Pacific Alliance Medical Center | $4,605 | 126% |
| Private Pay | $4,605 | 126% |
| Self-Pay | $4,605 | 126% |
| Tricare | $4,605 | 126% |
| Molina Healthcare Of California | $4,758 | 130% |
| San Miguel Health Plan | $5,065 | 138% |
| Chinatown Service Center Pace | $5,526 | 151% |
| Ahmc Health | $5,756 | 157% |
| Knox-Keene Act | $5,756 | 157% |
| Fmc Los Angeles County | $5,818 | 159% |
| Interplan Health Group | $5,941 | 162% |
| Athens Administrators Ahmc Work Comp | $6,125 | 167% |
| Misc 1 | $6,125 | 167% |
| Multiplan Wc | $6,125 | 167% |
| Healthnet | $11,476 - $13,820 | 314% |