CMS Price Transparency Data

Inguinal hernia repair

Facility: Adventist Health Tehachapi Valley

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $584
Cash Discount Price: $279
vs. Medicare Baseline: 0.16x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at Adventist Health Tehachapi Valley is $584. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $279. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.16x the Medicare baseline. Located in 1100 Magellan, Tehachapi, CA.

Cash / Self-Pay

$279

Average discount available for prompt cash payment at this facility.

Insurance Median

$584

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: $279 (8%)

Insurance Median: $584 (16%)

Cash: $279 (8% of Medicare)

Ins. Median: $584 (16% 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
Medi-Cal	$69	2%
Universal Ipa Mcal Op/Profee Only	$69	2%
Aetna	$467	13%
Healthnet Mcare	$503	14%
Tricare	$503	14%
UnitedHealthcare	$503 - $691	14%
Universal Ipa Mcr Adv Op/Profee Only-All Other Pla	$503	14%
Network Providers- All Plans	$549	15%
Ah Employee Health Plan - All Plans	$554	15%
Oscar Health Plan- All Plans	$579	16%
Cigna	$589	16%
Coventry- All Plans	$604	17%
Western Grwrs/Pinnacle - All Plans	$700	19%
Blue Shield Epn- All Other Plans	$706	19%
Healthnet- All Other Plans	$734	20%
Blue Shield Non-Epn	$746	20%
Centivo - All Plans	$755	21%
Blue Cross Blue Shield	$919	25%

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 $279.
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 Adventist Health Tehachapi Valley 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.