CMS Price Transparency Data

Inguinal hernia repair

Facility: Coalinga Regional Medical Center

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $336
  • Cash Discount Price: $260
  • vs. Medicare Baseline: 0.09x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Coalinga Regional Medical Center is $336. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $260. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.09x the Medicare baseline. Located in 1191 Phelps Avenue, Coalinga, CA.
Cash / Self-Pay
$260

Average discount available for prompt cash payment at this facility.

Insurance Median
$336

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: $260 (7%)
Insurance Median: $336 (9%)
Cash: $260 (7% of Medicare)
Ins. Median: $336 (9% 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.

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
Blue Cross Blue Shield $87 - $434 2%
Healthnet Mcr Adv $87 2%
Department Of State Hosp - All Plans $113 3%
Healthnet Prison $113 3%
Cigna $304 8%
Aetna $369 10%
Healthnet Mcal $434 12%
Medi-Cal $434 12%
Healthnet Hmo/Ppo - All Other Plans $5,487 150%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1191 Phelps Avenue, Coalinga, CA 93210
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals