CMS Price Transparency Data

Inguinal hernia repair

Facility: Santa Rosa Medical Center

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $3,863
  • Cash Discount Price: $9,818
  • vs. Medicare Baseline: 1.06x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Santa Rosa Medical Center is $3,863. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $9,818. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 1.06x the Medicare baseline. Located in 6002 Berryhill Rd, Milton, FL.
Cash / Self-Pay
$9,818

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,863

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: $9,818 (268%)
Insurance Median: $3,863 (106%)
Cash: $9,818 (268% of Medicare)
Ins. Median: $3,863 (106% 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%
Medicaid / KanCare $2,501 - $2,902 68%
Humana $2,576 - $3,679 70%
Wellcare $2,627 72%
Molina $2,827 77%
Fl Community Care $2,877 79%
Tricare $3,552 97%
Aetna $3,679 - $36,720 101%
Blue Cross Blue Shield $3,679 - $26,302 101%
Cigna $3,679 - $14,793 101%
Medicare (plans) $3,679 101%
UnitedHealthcare $3,679 - $12,698 101%
Node Champva $3,739 102%
Node Va $3,739 102%
Node Wellcare Mcr Adv $3,863 106%
Prime Health Work Comp Fl $4,356 119%
Florida Workers Compensation $4,490 123%
Geo Group $4,674 128%
Node Us Dept Of Labor $4,674 128%
Florida State Auto Insurance $7,478 204%
Ambetter / Centene $8,936 244%
Oscar $11,270 308%
Self Pay $15,055 412%
Hospice Of Nw Fl $32,727 895%
Prime Health Services $52,364 1432%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6002 Berryhill Rd, Milton, FL 32570
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals