CMS Price Transparency Data

Inguinal hernia repair

Facility: North Okaloosa Medical Center

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $4,533
  • Cash Discount Price: $25,244
  • vs. Medicare Baseline: 1.24x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at North Okaloosa Medical Center is $4,533. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $25,244. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 1.24x the Medicare baseline. Located in 151 Redstone Ave Se, Crestview, FL.
Cash / Self-Pay
$25,244

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,533

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: $25,244 (690%)
Insurance Median: $4,533 (124%)
Cash: $25,244 (690% of Medicare)
Ins. Median: $4,533 (124% 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
Veterans Eval Services $534 15%
Amerigroup $2,501 68%
Medicaid / KanCare $2,501 68%
UnitedHealthcare $2,501 - $27,768 68%
Simply Healthcare $2,551 - $3,863 70%
Humana $2,576 - $3,863 70%
Integral Health $2,627 72%
Wellcare $2,627 - $3,789 72%
Magellan Health $2,689 74%
Prestige Health $2,902 79%
Aetna $3,679 - $105,182 101%
Blue Cross Blue Shield $3,679 - $15,402 101%
Cigna $3,679 - $109,389 101%
Medicare (plans) $3,679 101%
Node Non Par Hospice Agree $3,739 102%
Node Va $3,739 102%
Florida Department Of Corrections $4,047 111%
Evolutions $4,486 - $123,413 123%
Usa Managed Care Work Comp Fl $4,486 123%
Prime Health Work Comp Fl $4,581 125%
Node Us Dept Of Labor $4,674 128%
Amcomp Workers Comp $4,722 129%
State Auto Insurance Fl $7,478 204%
Occunet $9,347 256%
Tricare $10,570 289%
Oscar $10,836 296%
Node Champva $11,126 304%
Self Pay $25,244 690%
Corizon Health Inc $47,402 1296%
Phcs $126,218 3451%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 151 Redstone Ave Se, Crestview, FL 32539
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals