CMS Price Transparency Data

Inguinal hernia repair

Facility: Winter Haven Hospital

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $7,010
  • Cash Discount Price: $8,497
  • vs. Medicare Baseline: 1.92x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Winter Haven Hospital is $7,010. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8,497. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 1.92x the Medicare baseline. Located in 200 Ave F Ne, Winter Haven, FL.
Cash / Self-Pay
$8,497

Average discount available for prompt cash payment at this facility.

Insurance Median
$7,010

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: $8,497 (232%)
Insurance Median: $7,010 (192%)
Cash: $8,497 (232% of Medicare)
Ins. Median: $7,010 (192% 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
Clear Health Alliance $2,526 69%
Molina $2,549 - $8,369 70%
Simply Healthcare $2,549 - $2,627 70%
UnitedHealthcare $2,551 - $12,745 70%
Humana $2,602 - $4,428 71%
Freedom Health $2,627 72%
Molina Healthcare $2,627 72%
Sunshine Health $2,627 72%
Aetna $2,677 - $11,541 73%
Florida Community Care $2,752 75%
Baycareplus $3,542 97%
Blue Cross Blue Shield $3,542 - $8,161 97%
Careplus $3,554 97%
Freedom $3,822 104%
Optimum $3,822 104%
Solis Health $3,897 107%
Cigna $4,074 - $12,320 111%
Health First $4,074 111%
Ultimate Health Plan $4,248 116%
Avmed $4,390 - $6,939 120%
Wellcare $4,959 136%
Florida Hospital $6,514 178%
Evolutions $7,080 - $13,170 194%
Ambetter / Centene $7,970 - $14,161 218%
Multiplan $11,329 310%
First Health $12,037 329%
United Behavioral Health $14,161 387%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 200 Ave F Ne, Winter Haven, FL 33881
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals