CMS Price Transparency Data

Inguinal hernia repair

Facility: Halifax Health Medical Center

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $3,542
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.97x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Halifax Health Medical Center is $3,542. 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 0.97x the Medicare baseline. Located in 303 N Clyde Morris Blvd, Daytona Beach, FL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,542

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: $3,542 (97%)
Ins. Median: $3,542 (97% 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
Coventry $2,350 - $3,542 64%
Hcra $2,350 64%
Humana $2,350 - $7,049 64%
Medicaid / KanCare $2,350 64%
Molina $2,350 - $3,613 64%
UnitedHealthcare $2,350 - $3,542 64%
West Volusia $2,350 64%
Aetna $2,468 - $7,166 67%
Independent Living Systems $2,468 - $3,720 67%
Simply Healthcare Plans $2,468 67%
Sunshine State Health Plan $2,468 - $7,085 67%
Caresource Network $2,585 71%
Embs $3,011 82%
Tricare $3,185 87%
Americas Choice Provider Network $3,542 97%
Blue Cross Blue Shield $3,542 97%
Cigna $3,542 97%
Division Of The Blind $3,542 97%
Freedom Health $3,542 97%
Medicare (plans) $3,542 97%
Optimum Healthcare $3,542 97%
Wellcare $3,542 97%
Devoted Health $3,684 101%
Longevity $3,720 102%
Prime Health Services $3,720 102%
Clear Spring Health Of Fl $3,861 106%
Employers Health Network $7,085 194%
Fhcp $7,156 196%
Centivo $7,616 208%
Florida Healthcare $7,687 210%
Claimdoc $7,970 218%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 303 N Clyde Morris Blvd, Daytona Beach, FL 32114
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals