CMS Price Transparency Data
Inguinal hernia repair
Facility: Anaheim Global Medical Center
Billing Code: 49505 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 49505
- Insurance Median: $5,573
- Cash Discount Price: $18,138
- vs. Medicare Baseline: 1.52x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Anaheim Global Medical Center is $5,573. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $18,138. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 1.52x the Medicare baseline. Located in 1025 S Anaheim Blvd, Anaheim, CA.
Cash / Self-Pay
$18,138
Average discount available for prompt cash payment at this facility.
Insurance Median
$5,573
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%)
Cash / Self-Pay: $18,138 (496%)
Insurance Median: $5,573 (152%)
Cash: $18,138 (496% of Medicare)
Ins. Median: $5,573 (152% 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 |
|---|---|---|
| Medi-Cal Hmo/Non Contract | $344 | 9% |
| Brand New Day | $413 - $5,756 | 11% |
| Healthcare Partners | $493 | 13% |
| Hollywood Presbyterian | $493 | 13% |
| Kaiser | $493 - $11,169 | 13% |
| Prime Health Services | $493 - $15,417 | 13% |
| State Of California | $493 - $6,125 | 13% |
| Altamed | $691 - $4,582 | 19% |
| Caloptima | $691 - $4,605 | 19% |
| Choc Health Alliance | $691 | 19% |
| County Of Orange | $691 - $18,138 | 19% |
| Family Choice Mcal | $691 | 19% |
| Heritage Provider Network | $691 - $6,677 | 19% |
| Prospect Health Plan | $691 - $6,907 | 19% |
| Ihhi Reciprocity | $1,200 | 33% |
| Aetna | $3,305 - $4,582 | 90% |
| Altamed Health Services | $4,353 - $4,582 | 119% |
| Champus | $4,421 | 121% |
| Astiva | $4,582 | 125% |
| Blue Shield Of California | $4,582 - $17,459 | 125% |
| California Health Plan | $4,582 | 125% |
| Central Health Plan Of California Inc | $4,582 | 125% |
| Champion Health Plan | $4,582 | 125% |
| Citizens Choice | $4,582 | 125% |
| Clever Care Health Plan | $4,582 | 125% |
| Easy Choice | $4,582 | 125% |
| For Your Benefit | $4,582 | 125% |
| Health Net Inc | $4,582 - $9,690 | 125% |
| Healthcare Partners Sr Hmo | $4,582 | 125% |
| Hollywood Presbyerian | $4,582 | 125% |
| Humana | $4,582 | 125% |
| Medicare (plans) | $4,582 | 125% |
| Monarch | $4,582 | 125% |
| Onecare | $4,582 | 125% |
| Other Sr Non Contract | $4,582 | 125% |
| Physicians For Healthy Hospitals | $4,582 | 125% |
| Scan | $4,582 | 125% |
| St Joseph Hospital Sr | $4,582 | 125% |
| UnitedHealthcare | $4,582 - $6,232 | 125% |
| Us Federal Marshall/Department Of Immigration | $4,582 | 125% |
| Velocity National Provider Network Sr | $4,582 | 125% |
| Verda Health Plan | $4,582 | 125% |
| Veterans Administration | $4,582 | 125% |
| Choice Physicians Network | $4,605 | 126% |
| Imperial Health Plan Of Ca | $4,605 | 126% |
| Innovative Integrated Health | $4,605 | 126% |
| Medcare Partners Health Plan | $4,605 | 126% |
| Self Pay/Ab774/Cbo Use Only | $4,605 | 126% |
| Us Dept Of Labor | $4,605 | 126% |
| Victim Of Violent Crime | $4,605 | 126% |
| Victim Of Violent Crime (Mep) | $4,605 | 126% |
| Victoria Hospice | $4,605 | 126% |
| Monarch Health Plan | $4,787 - $6,025 | 131% |
| Healthcare Partners Hmo | $4,973 | 136% |
| Align Sr Care | $5,132 | 140% |
| Primecare Medical Network Inc | $5,500 | 150% |
| Coventry Health | $5,512 - $5,726 | 151% |
| Interplan | $5,573 - $13,604 | 152% |
| Veterans Evaluation Services | $5,756 | 157% |
| Multiplan | $6,002 - $35,000 | 164% |
| Three Rivers Network | $6,002 - $8,059 | 164% |
| Velocity National Provider Network Wc | $6,125 | 167% |
| Staywell/Island Home Ins | $6,447 | 176% |
| Health Net | $6,493 - $8,670 | 178% |
| Naphcare | $7,138 | 195% |
| Velocity National Provider Network Ppo | $8,059 | 220% |
| Velocity National Provider Network Auto Med Ppo | $8,162 | 223% |
| Networks By Design | $8,500 | 232% |
| Cigna | $8,806 - $14,510 | 241% |
| First Health | $9,522 | 260% |
| Magellan Behavioral Health | $10,883 | 298% |
| Healthsmart Preferred Network | $13,604 - $37,500 | 372% |
| Provider Network Of America | $14,510 | 397% |
| Ahmc Healthcare | $18,138 | 496% |
| Altamed Mcal Hmo (Ancillary) | $18,138 | 496% |
| Lucet Bh Scan Sr | $18,138 | 496% |
| Managed Health Network | $18,138 | 496% |
| Other Insurance Loa | $18,138 | 496% |
| Other Non Contracted Plans | $18,138 | 496% |
| Private Pay | $18,138 | 496% |
| Usbhpc | $18,138 | 496% |