CMS Price Transparency Data

Inguinal hernia repair

Facility: Atrium Health Navicent Peach

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $1,556
Cash Discount Price: $3,633
vs. Medicare Baseline: 0.43x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at Atrium Health Navicent Peach is $1,556. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,633. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.43x the Medicare baseline. Located in 1960 Highway 247 Connector, Byron, GA.

Cash / Self-Pay

$3,633

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,556

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: $3,633 (99%)

Insurance Median: $1,556 (43%)

Cash: $3,633 (99% of Medicare)

Ins. Median: $1,556 (43% 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
Blue Cross Blue Shield	$510 - $3,016	14%
Alliant	$568 - $3,297	16%
Aetna	$576 - $4,286	16%
Georgia Health Advantage	$576 - $1,526	16%
Humana	$576 - $6,175	16%
UnitedHealthcare	$576 - $4,577	16%
Care Source	$588 - $1,556	16%
Clover	$588 - $1,556	16%
Eon Health	$588 - $1,556	16%
Pruitt Health	$605 - $1,526	17%
Ambetter / Centene	$651 - $3,705	18%
Cigna	$838 - $5,289	23%
Securehealth	$1,020 - $4,722	28%
Multiplan	$4,722 - $5,812	129%
Novanet	$5,812	159%
Three Rivers Provider Network	$6,175	169%
Beechstreet	$6,756	185%

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 $3,633.
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 Atrium Health Navicent Peach 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.