CMS Price Transparency Data

Inguinal hernia repair

Facility: HCA Florida Jfk Hospital

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $8,253
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 2.26x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at HCA Florida Jfk Hospital is $8,253. 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 2.26x the Medicare baseline. Located in 5301 S Congress Ave, Atlantis, FL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$8,253

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: $8,253 (226%)
Ins. Median: $8,253 (226% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 226% of the Medicare baseline (a markup of 126%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

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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
Optimum $2,350 - $4,575 64%
Aids Healthcare $2,450 67%
Simply Healthcare Plans $3,792 104%
Freedom Health $3,950 - $4,575 108%
Molina $3,950 - $5,211 108%
Health Sun Health Plan $4,200 115%
Avmed $4,281 - $9,160 117%
Medica Healthcare $4,500 123%
Corvel Corporation $4,660 - $13,258 127%
Mmm Of Fl (Health Advantage Plan) $4,750 130%
Careworks (Rockport) $4,758 - $13,537 130%
Prime Health $4,758 - $13,537 130%
Sunshine State Health Plan $4,963 136%
Cigna $6,802 186%
Simply Healthcare $7,583 207%
Oscar $8,392 229%
Amerihealth Caritas $11,447 313%
Blue Cross Blue Shield $13,617 - $18,507 372%
United $20,200 552%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5301 S Congress Ave, Atlantis, FL 33462
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals