CMS Price Transparency Data

Inguinal hernia repair

Facility: HCA Florida Lawnwood Hospital

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $6,361
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.74x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at HCA Florida Lawnwood Hospital is $6,361. 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 1.74x the Medicare baseline. Located in 1700 S 23Rd St, Fort Pierce, FL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$6,361

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: $6,361 (174%)
Ins. Median: $6,361 (174% 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
Freedom Health $2,350 - $4,575 64%
Optimum $2,350 - $4,575 64%
Cigna $2,555 - $15,153 70%
Simply Healthcare Plans $3,792 104%
Molina $3,950 - $5,211 108%
Health Sun Health Plan $4,200 115%
Avmed $4,281 117%
Corvel Corporation $4,624 - $13,157 126%
Careworks (Rockport) $4,721 - $13,434 129%
Prime Health $4,721 - $13,434 129%
Blue Cross Blue Shield $4,765 - $24,677 130%
Pinnacol Workers Comp $5,324 146%
United $5,339 - $33,200 146%
Multiplan $5,548 152%
Aetna $5,806 - $8,799 159%
Sunshine State Health Plan $6,625 181%
Rocky Mountain Health Plan $9,421 258%
Oscar $12,772 349%
Simply Healthcare $13,422 367%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1700 S 23Rd St, Fort Pierce, FL 34950
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals