CMS Price Transparency Data
Inguinal hernia repair
Facility: Children's Hosp of Los Angeles
Billing Code: 49505 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 49505
- Insurance Median: $1,012
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.28x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Children's Hosp of Los Angeles is $1,012. 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 0.28x the Medicare baseline. Located in 4650 Sunset Blvd, Ms 108, Los Angeles, CA.
Cash / Self-Pay
Unavailable
Average discount available for prompt cash payment at this facility.
Insurance Median
$1,012
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: $1,012 (28%)
Ins. Median: $1,012 (28% 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 |
|---|---|---|
| Altamed | $482 - $15,429 | 13% |
| Caloptima | $482 | 13% |
| Medi-Cal | $493 | 13% |
| Valley Presbyterian Hospital | $493 | 13% |
| Choc Health Alliance | $617 | 17% |
| Health Net | $617 | 17% |
| St Francis Medical Center | $641 - $952 | 18% |
| Bella Vista Med Grp | $720 | 20% |
| Centinela Valley Ipa | $720 | 20% |
| El Proyecto Del Barrio | $720 | 20% |
| Global Care Medical Group | $720 | 20% |
| Health Care La Ipa | $720 | 20% |
| Premier Physicians Ntwk | $720 | 20% |
| Watts Healthcare Mmc | $720 | 20% |
| Community Family Care Ipa | $740 | 20% |
| Hollywood Presbyterian Medical Center | $740 | 20% |
| Heritage Provider Network | $790 - $17,953 | 22% |
| Blue Cross Blue Shield | $813 - $6,078 | 22% |
| La Care | $819 - $15,709 | 22% |
| Serra Community Med Clinic | $846 | 23% |
| Care 1St | $864 | 24% |
| White Memorial Medical Center | $864 | 24% |
| Adventist Health Physicians | $888 - $16,831 | 24% |
| Cal Care Ipa | $898 | 25% |
| Associated Hispanic Physicians Ipa | $913 | 25% |
| Gold Coast Health Plan | $913 | 25% |
| Hispanic Physician Ipa | $913 | 25% |
| Serendib Healthways Mmc | $913 | 25% |
| Beverly Hospital | $918 | 25% |
| Los Angeles Medical Center Ipa | $923 | 25% |
| San Judas Med Grp | $923 | 25% |
| Alhambra Hospital Medical Center | $928 | 25% |
| Accountable Health | $942 | 26% |
| Souther California Hosp System - Mmc | $946 | 26% |
| Cencal Health | $952 | 26% |
| Pacific Alliance Medical Center | $967 | 26% |
| Blue Shield | $977 - $5,994 | 27% |
| Angeles Ipa | $987 | 27% |
| Crown City Medical Group | $987 | 27% |
| Employee Health Systems Med Grp | $987 | 27% |
| Point Comfort Underwriters | $987 | 27% |
| Seaside Health Plan | $987 | 27% |
| Imperial Health Holdings Medical Group | $1,007 | 28% |
| Karing Physicians Medical Group | $1,007 | 28% |
| Noble Community Medical Associates | $1,007 | 28% |
| Regent Medical Group | $1,007 | 28% |
| Avalon Ipa | $1,012 | 28% |
| Exceptional Care Medical Group | $1,012 - $21,413 | 28% |
| Mabuhay Medical Group | $1,012 | 28% |
| Preferred Ipa | $1,012 | 28% |
| Primary Care And Pediatric Ipa | $1,012 | 28% |
| Inland Empire Health Plan | $1,017 | 28% |
| Family Care Specialists | $1,041 | 28% |
| Molina | $1,041 | 28% |
| Family Health Alliance Med Grp | $1,061 | 29% |
| Applecare Medical Group | $1,091 - $18,234 | 30% |
| Community Care Ipa Mmc | $1,091 | 30% |
| Dignity Health | $1,095 | 30% |
| Allied Pacific Ipa | $1,160 | 32% |
| Asian Community Medical Group | $1,174 | 32% |
| California Pacific Physicians Medical Group | $1,174 | 32% |
| Healthy New Life Medical Corp | $1,174 | 32% |
| Kern Family Health Plan | $1,243 | 34% |
| Superior Choice Medical Group | $1,337 | 37% |
| Southland San Gabriel Valley Medical Group | $1,347 | 37% |
| Champus | $4,467 | 122% |
| Cigna | $4,660 | 127% |
| UnitedHealthcare | $6,719 - $12,259 | 184% |
| Medicare (plans) | $9,182 | 251% |
| Accarent Health | $9,351 | 256% |
| Sierra Health And Life Insurance Company | $10,000 | 273% |
| Delta Health Systems | $11,564 | 316% |
| Incentive Health Network | $17,299 | 473% |
| Gemcare Ipa | $17,953 | 491% |
| Managed Care Systems | $18,234 | 498% |
| Providence Health Network | $18,701 | 511% |
| Ventura County Health Plan | $23,844 | 652% |
| Staywell Insurance | $25,000 | 683% |
| Good Samaritan Medical Group | $25,714 | 703% |
| Access Medical Group | $25,995 | 711% |
| Seoul Medical Group | $28,706 | 785% |
| Southern Atlantic Medical Group Mmc | $30,619 | 837% |