CMS Price Transparency Data

Inguinal hernia repair

Facility: Lower Keys Medical Center

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $4,396
  • Cash Discount Price: $14,550
  • vs. Medicare Baseline: 1.20x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Lower Keys Medical Center is $4,396. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $14,550. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 1.20x the Medicare baseline. Located in 5900 College Road, Key West, FL.
Cash / Self-Pay
$14,550

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,396

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: $14,550 (398%)
Insurance Median: $4,396 (120%)
Cash: $14,550 (398% of Medicare)
Ins. Median: $4,396 (120% 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
UnitedHealthcare $62 - $41,440 2%
Veterans Eval Services $534 15%
Simply Healthcare $3,000 - $4,197 82%
Florida Childrens Medical Services $3,816 104%
Medicaid / KanCare $3,816 - $4,197 104%
South Florida Community Care Network $3,816 104%
Humana $3,930 - $3,940 107%
Blue Cross Blue Shield $3,940 - $63,496 108%
Medicare (plans) $3,940 108%
Ultimate Health $3,940 108%
Node Non Par Hospice Agree $4,004 109%
Node United Behavioral Va Ccn $4,004 109%
Node Va $4,004 109%
Amerigroup $4,197 115%
Positive Healthcare $4,197 115%
Wellcare $4,197 115%
Wellcare Healthease $4,197 115%
Prime Health Work Comp Fl $4,264 117%
Molina $4,312 118%
Fl Work Comp $4,396 120%
Heritage Summit Work Comp Fl $4,396 120%
Correct Care Solutions $4,405 120%
Prestige Health Choice $4,426 121%
Magellan $4,579 125%
Node Us Dept Of Labor $5,006 137%
Tricare $6,004 164%
Node Champva $6,320 173%
State Auto Insurance Fl $8,009 219%
Self Pay $14,550 398%
Cigna $31,794 869%
Aetna $37,614 1028%
Monroe County $40,416 1105%
Evolutions Healthcare Systems $43,110 - $51,193 1179%
Keys Energy $43,110 1179%
Prime Health Ppo $43,110 1179%
Avmed Health Plan $45,804 1252%
Direct Healthcare $53,888 1473%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5900 College Road, Key West, FL 33040
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals