CMS Price Transparency Data

Inguinal hernia repair

Facility: Davis County Hospital

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $474
  • Cash Discount Price: $1,286
  • vs. Medicare Baseline: 0.13x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Davis County Hospital is $474. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,286. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.13x the Medicare baseline. Located in 509 North Madison Street, Bloomfield, IA.
Cash / Self-Pay
$1,286

Average discount available for prompt cash payment at this facility.

Insurance Median
$474

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: $1,286 (35%)
Insurance Median: $474 (13%)
Cash: $1,286 (35% of Medicare)
Ins. Median: $474 (13% 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
Midlands Choice - All Plans $67 2%
Aetna $451 12%
Choicecare Mcr Adv $451 12%
Home State Hlth Exch - All Other Plans $451 12%
Home State Hlth Mcr $451 12%
Tricare $451 12%
Amerigroup Mcr Adv-All Other Plans $460 13%
American Hp Mcr Adv-All Plans $474 13%
Mt Carmel Hp-All Plans $474 13%
Choicecare Comm - All Other Plans $677 19%
Preferred Hlth Choices - All Plans $858 23%
Blue Cross Blue Shield $1,014 - $1,193 28%
Home State Hlth Mcaid $1,286 35%
Iowa Total Care Mcaid-All Plans $1,312 36%
Molina Mcaid-All Plans $1,318 36%
Amerigroup Mcaid $1,325 36%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 509 North Madison Street, Bloomfield, IA 52537
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals