CMS Price Transparency Data

Inguinal hernia repair

Facility: Boulder Community Health

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $904
  • Cash Discount Price: $519
  • vs. Medicare Baseline: 0.25x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Boulder Community Health is $904. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $519. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.25x the Medicare baseline. Located in 4747 Arapahoe Avenue, Boulder, CO.
Cash / Self-Pay
$519

Average discount available for prompt cash payment at this facility.

Insurance Median
$904

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: $519 (14%)
Insurance Median: $904 (25%)
Cash: $519 (14% of Medicare)
Ins. Median: $904 (25% 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
Medicare (plans) $394 - $3,653 11%
Select Health Colorado Public Option $394 - $7,803 11%
Select Health Value Network $394 - $8,264 11%
Aetna $395 - $3,547 11%
Devoted Health $415 - $3,547 11%
Medicaid / KanCare $431 12%
Rocky Mountain Health Maintenance Organization $431 - $3,653 12%
Colorado Access $474 - $1,366 13%
Blue Cross Blue Shield $517 - $13,401 14%
Health Spring $517 - $3,547 14%
Humana $517 - $3,547 14%
UnitedHealthcare $517 - $3,644 14%
Clear Spring $532 - $3,653 15%
Multiplan $717 - $832 20%
Phcs $717 - $832 20%
Rocky Mountain Health Maintenance Organization Private Plan $727 20%
Integrated Health Plans Bch $778 21%
Kaiser Ppo $796 - $8,349 22%
Kaiser Public Option $796 - $6,802 22%
Beech Street Community Medical Associates $802 22%
Cigna $830 - $7,204 23%
Casualty Management Network, Prime Health Services Behavioral Health $882 24%
Mines And Associates $882 24%
Three Rivers Provider Network $882 24%
Zelis (Profee) $882 24%
Casualty Management Network, Prime Health Services Community Medical Associates $934 26%
National Preferred Provider Network $934 26%
Rockport Healthcare Group Community Medical Associates $934 26%
Usa $934 26%
Rockport Healthcare Group Bch $965 26%
Health Payors Organization $986 27%
Health Management Network Bch Community Medical Associates $996 27%
Health Management Network Community Medical Associates $996 27%
National Provider Network $1,007 28%
Kaiser $8,310 227%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4747 Arapahoe Avenue, Boulder, CO 80304
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals