CMS Price Transparency Data

Inguinal hernia repair

Facility: Lutheran Hospital of Indiana

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $891
  • Cash Discount Price: $563
  • vs. Medicare Baseline: 0.24x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Lutheran Hospital of Indiana is $891. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $563. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.24x the Medicare baseline. Located in 7950 W Jefferson Blvd, Fort Wayne, IN.
Cash / Self-Pay
$563

Average discount available for prompt cash payment at this facility.

Insurance Median
$891

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: $563 (15%)
Insurance Median: $891 (24%)
Cash: $563 (15% of Medicare)
Ins. Median: $891 (24% 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
Physicians Health Plan Of Northern Indiana $121 - $18,495 3%
Ky Work Comp $123 - $11,804 3%
Amish Aid $147 - $14,054 4%
Lutheran Preferred Network $147 - $28,108 4%
Self Pay $147 - $14,054 4%
Cigna $158 - $17,005 4%
Php Freedom Network $162 - $15,548 4%
Blue Cross Blue Shield $181 - $17,380 5%
Aetna $196 - $22,299 5%
Lutheran Preferred $196 - $1,616 5%
Sagamore $223 - $25,344 6%
Encore Ppo $239 - $22,908 7%
Lutheran Network $244 - $23,423 7%
Multiplan $357 - $38,882 10%
Prime Health Services $367 - $35,135 10%
Encore Health Network $401 - $42,161 11%
Advantage Health Solutions $406 - $38,882 11%
Allied Benefit Systems $440 - $42,161 12%
Evolutions $440 - $42,161 12%
One Call Care Diagnostics $460 13%
Veterans Eval Services $467 13%
Care Source $2,274 62%
Humana $2,274 - $3,727 62%
Managed Health Services $2,274 - $7,576 62%
Medicaid / KanCare $2,274 62%
UnitedHealthcare $2,274 - $9,100 62%
Iu Health Plan $3,727 102%
Medicare (plans) $3,727 102%
Node Hospice Non Par Agree $3,788 104%
Node Va $3,788 104%
Node Devoted Health Mcr Adv $3,802 104%
In Dept Of Correction $3,940 108%
Node Pphp Mcr Adv $3,978 109%
Us Department Of Labor $4,735 129%
Tricare $5,434 149%
Lutheran Advanced Network $5,682 155%
Node Lutheran Network $5,682 - $6,629 155%
Node Lutheran Preferred Fixed 2 $5,682 155%
Department Of Veterans Affairs $5,720 156%
Align Network $6,061 166%
Encore Work Comp In $6,819 186%
Node Encore Kba Epo $9,091 249%
Node Encore Kba Ppo $11,364 311%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7950 W Jefferson Blvd, Fort Wayne, IN 46804
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals