CMS Price Transparency Data

Inguinal hernia repair

Facility: Jefferson County Health Center

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $795
  • Cash Discount Price: $1,039
  • vs. Medicare Baseline: 0.22x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Jefferson County Health Center is $795. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,039. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.22x the Medicare baseline. Located in 2000 S Main, Fairfield, IA.
Cash / Self-Pay
$1,039

Average discount available for prompt cash payment at this facility.

Insurance Median
$795

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: $1,039 (28%)
Insurance Median: $795 (22%)
Cash: $1,039 (28% of Medicare)
Ins. Median: $795 (22% 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 $589 - $1,559 16%
Tricare $672 18%
Amerigroup Mcr Adv $693 19%
Humana $693 19%
Iowa Total Care Comm - All Other Plans $693 19%
Iowa Total Care Mcr $693 19%
Molina Mcr Adv $693 19%
Iowa Total Care Mcaid $727 20%
Molina Mcaid/Chip $727 20%
Medicaid / KanCare $742 20%
Aetna $849 - $1,559 23%
Medicare (plans) $849 23%
Midlands New Product $1,420 39%
Coventry Commercial Hmo $1,472 40%
Coventry Commercial Ppo - All Other Plans $1,559 43%
Midlands Choice-All Other Plans $1,559 43%
Molina Marketplace - All Other Plans $1,732 47%
Wellmark Hmo $6,139 168%
Wellmark Indemnity/Ppo - All Other Plans $6,755 185%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2000 S Main, Fairfield, IA 52556
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals