CMS Price Transparency Data

Inguinal hernia repair

Facility: Goshen Hospital

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $3,403
  • Cash Discount Price: $9,472
  • vs. Medicare Baseline: 0.93x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Goshen Hospital is $3,403. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $9,472. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.93x the Medicare baseline. Located in 200 High Park Ave, Goshen, IN.
Cash / Self-Pay
$9,472

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,403

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: $9,472 (259%)
Insurance Median: $3,403 (93%)
Cash: $9,472 (259% of Medicare)
Ins. Median: $3,403 (93% 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
Advantage Health Solutions $3,403 93%
Aetna $3,403 93%
Atrio Health Plans $3,403 93%
Bc Federal Employee $3,403 93%
Bc Mcr Advantage Ppo $3,403 93%
Blue Cross Blue Shield $3,403 93%
Buckeye Health Plan $3,403 93%
Cigna $3,403 93%
Coventry Health And Life $3,403 93%
Emblem Health $3,403 93%
Freedom Healthcare $3,403 93%
Geisinger Health Plan $3,403 93%
Health First $3,403 93%
Healthspring $3,403 93%
Humana $3,403 93%
Iehp Empire Health Plan $3,403 93%
Independent Care Health Plan $3,403 93%
Kaiser Permanente $3,403 93%
Mcr Advantra Freedom $3,403 93%
Mcr Allwell Mhs $3,403 93%
Mcr Banner Health $3,403 93%
Mcr Complete $3,403 93%
Mcr Complete Ppo $3,403 93%
Mcr Complete Wellmed $3,403 93%
Mcr Health Alliance $3,403 93%
Mcr Health Partners Plans $3,403 93%
Mcr Medical Mutual Of Ohio $3,403 93%
Mcr Passport Advantage $3,403 93%
Mcr Secure Horizons Ppo $3,403 93%
Mcr Texan Plus $3,403 93%
Mcr Upmc For Life $3,403 93%
Medicare (plans) $3,403 - $3,608 93%
Meridian Complete $3,403 93%
Optimum Healthcare $3,403 93%
Paramount Elite $3,403 93%
Primetime Health Plan $3,403 93%
Simply Complete Hmo $3,403 93%
The Umwa H&R Funds $3,403 93%
Todays Options Pyramid Life $3,403 93%
Trillium Advantage $3,403 93%
Ucare For Seniors $3,403 93%
Ucare Minnesota $3,403 93%
UnitedHealthcare $3,403 93%
Wellcare $3,403 93%
Champva $3,502 96%
Tricare $3,502 96%
Mcr Devoted Health Plan $3,608 99%
Mcr Provider Partners Hlth Pln $3,853 105%
Ambetter / Centene $4,903 134%
Mkt Caresource $4,903 134%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 200 High Park Ave, Goshen, IN 46526
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals