CMS Price Transparency Data
Inguinal hernia repair
Facility: Coastal Communities Hospital
Billing Code: 49505 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 49505
- Insurance Median: $5,713
- Cash Discount Price: $18,138
- vs. Medicare Baseline: 1.56x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Coastal Communities Hospital is $5,713. 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 1.56x the Medicare baseline. Located in 2701 S Bristol St, Santa Ana, CA.
Cash / Self-Pay
$18,138
Average discount available for prompt cash payment at this facility.
Insurance Median
$5,713
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: $5,713 (156%)
Cash: $18,138 (496% of Medicare)
Ins. Median: $5,713 (156% 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 |
|---|---|---|
| Kpc Healthcare Inc | $413 - $5,756 | 11% |
| Healthcare Partners | $493 | 13% |
| Hollywood Presbyterian | $493 - $4,582 | 13% |
| Kaiser | $493 - $11,169 | 13% |
| Medi-Cal Hmo/Non Contract | $493 | 13% |
| Medicaid / KanCare | $493 | 13% |
| Altamed Health Services | $691 - $4,582 | 19% |
| Caloptima | $691 - $4,605 | 19% |
| Choc Health Alliance | $691 | 19% |
| County Of Orange | $691 | 19% |
| Family Choice | $691 | 19% |
| Heritage Provider Network | $691 - $5,815 | 19% |
| Prospect Health Plan | $691 - $6,907 | 19% |
| Aetna | $3,305 | 90% |
| Champus | $4,421 | 121% |
| Blue Shield | $4,582 - $17,459 | 125% |
| Central Health Plan Of California | $4,582 | 125% |
| Champion Health Plan | $4,582 | 125% |
| Citizens Choice Health Plan | $4,582 | 125% |
| Clever Care Health Plan | $4,582 | 125% |
| For Your Benefit | $4,582 | 125% |
| Health Net | $4,582 - $7,900 | 125% |
| Healthcare Partners Sr Hmo | $4,582 | 125% |
| Heritage | $4,582 | 125% |
| Humana | $4,582 | 125% |
| Monarch | $4,582 - $5,699 | 125% |
| Onecare | $4,582 | 125% |
| Onecare Connect | $4,582 | 125% |
| Other Senior Non Contract | $4,582 | 125% |
| Scan Health Plan | $4,582 | 125% |
| UnitedHealthcare | $4,582 - $6,232 | 125% |
| Us Federal Marshall/Department Of Immigration | $4,582 | 125% |
| Velocity Provider Network Sr | $4,582 | 125% |
| Verda Health Plan Sr | $4,582 | 125% |
| Veterans Administration | $4,582 | 125% |
| Choice Physicians Network | $4,605 | 126% |
| Easy Choice Health Plan | $4,605 | 126% |
| Imperial Health Plan Of Ca | $4,605 | 126% |
| Innovative Integrated Health | $4,605 | 126% |
| Medcare Partners | $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% |
| Victoria Hospice | $4,605 | 126% |
| Brand New Day | $5,132 | 140% |
| Prime Health Srvs | $5,270 - $14,510 | 144% |
| Ihhi Reciprocity | $5,441 - $15,000 | 149% |
| Coventry Auto Network | $5,512 | 151% |
| Prime Health Srvs/Wc | $5,512 | 151% |
| Interplan | $5,573 - $13,604 | 152% |
| Coventry Wc | $5,726 | 157% |
| County Of Orange/Custody/Advanced Medmgt | $5,728 | 157% |
| Veterans Evaluation Services | $5,756 | 157% |
| Multiplan | $6,002 - $35,000 | 164% |
| Three Rivers | $6,002 | 164% |
| Monarch Health Plan | $6,096 | 167% |
| Velocity National Provider Network Wc | $6,125 | 167% |
| Workers Comp State Of California | $6,125 | 167% |
| Staywell/Island Home Ins | $6,447 | 176% |
| Three Rivers Network | $8,059 | 220% |
| Velocity National Provider Network Ppo | $8,059 | 220% |
| Networks By Design | $8,500 | 232% |
| Networks By Design Wc | $8,500 | 232% |
| Cigna | $8,806 - $11,790 | 241% |
| First Health | $9,522 | 260% |
| Magellan | $10,883 | 298% |
| Healthsmart | $13,604 - $37,500 | 372% |
| Prime Health | $13,604 | 372% |
| Pnoa-Provider Network Of America | $14,510 | 397% |
| Prime Health Srvs/Network | $15,417 | 421% |
| Altamed Mcal Hmo (Ancillary) | $18,138 | 496% |
| Lucet Behavioral Health 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% |
| Us Behavioral Health Plan | $18,138 | 496% |
| Vitas Hospice | $18,138 | 496% |