CMS Price Transparency Data

Inguinal hernia repair

Facility: Navicent Health Baldwin

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $3,456
Cash Discount Price: $3,561
vs. Medicare Baseline: 0.94x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at Navicent Health Baldwin is $3,456. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,561. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.94x the Medicare baseline. Located in 821 North Cobb Street, Milledgeville, GA.

Cash / Self-Pay

$3,561

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,456

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: $3,561 (97%)

Insurance Median: $3,456 (94%)

Cash: $3,561 (97% of Medicare)

Ins. Median: $3,456 (94% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Aetna	$501 - $5,910	14%
Blue Cross Blue Shield	$501 - $4,144	14%
Georgia Health Advantage	$501 - $3,439	14%
Humana	$501 - $6,053	14%
UnitedHealthcare	$501 - $7,667	14%
Care Source	$511 - $3,507	14%
Clover	$511 - $3,507	14%
Eon Health	$511 - $3,507	14%
Pruitt Health	$526 - $3,439	14%
Alliant	$601 - $4,421	16%
Ambetter / Centene	$676 - $3,632	18%
Cigna	$838 - $5,483	23%
Securehealth	$1,020 - $2,492	28%
Multiplan	$4,629 - $5,697	127%
Novanet	$5,697	156%
Three Rivers Provider Network	$6,053	165%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $3,561.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 49505.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Navicent Health Baldwin is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 49505.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.