CMS Price Transparency Data

Inguinal hernia repair

Facility: Bluffton Regional Medical Center

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $916
  • Cash Discount Price: $460
  • vs. Medicare Baseline: 0.25x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Bluffton Regional Medical Center is $916. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $460. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.25x the Medicare baseline. Located in 303 S Main St, Bluffton, IN.
Cash / Self-Pay
$460

Average discount available for prompt cash payment at this facility.

Insurance Median
$916

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: $460 (13%)
Insurance Median: $916 (25%)
Cash: $460 (13% of Medicare)
Ins. Median: $916 (25% 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
Amish Aid $117 - $703 3%
Self Pay $117 - $1,612 3%
Physicians Health Plan $119 - $710 3%
Lutheran Preferred Network $146 - $5,682 4%
Php Freedom Network $153 - $919 4%
Cigna $155 - $1,038 4%
Php $156 - $934 4%
Aetna $177 - $3,727 5%
Php Management Systems $189 - $1,135 5%
Lutheran Trma $196 - $1,319 5%
UnitedHealthcare $229 - $3,788 6%
Encore Ppo $239 - $1,433 7%
Sagamore Sebt $250 - $1,498 7%
Sagamore Health Newtork Inc $262 - $1,571 7%
Consumer Life $303 - $1,817 8%
Ahg Dana Employees $318 - $1,905 9%
Align Networks $342 - $2,052 9%
Prime Health Services $367 - $6,819 10%
Private Healthcare Systems Inc $367 - $2,198 10%
Multiplan $391 - $2,345 11%
Encore Health Network $401 - $2,638 11%
Advantage 360 $406 - $2,433 11%
Community Health Alliance $416 - $2,491 11%
First Health $421 - $2,521 12%
Allied Benefit Systems $440 - $2,638 12%
Cardinal Health Alliance $440 - $2,638 12%
Ppom $440 - $2,638 12%
Veterans Eval Services $467 13%
Blue Cross Blue Shield $3,727 - $15,567 102%
Medicare (plans) $3,727 102%
Node Iu Health Mcr Adv $3,727 102%
Node Mhs Mcr Adv $3,727 102%
Humana $3,788 104%
Node Non Par Hospice Agree $3,788 104%
Node Va $3,788 104%
Northeast Hospice $3,788 104%
Node Caresource Mcr Adv $3,802 104%
Node Devoted Health Mcr Adv $3,802 104%
County Jail Health Care $3,940 108%
In Dept Of Correction $3,940 108%
Node Pphp Mcr Adv $3,978 109%
Us Department Of Labor $4,735 129%
Lutheran Advanced Network $5,682 155%
Lutheran Three Rivers Preferred Plus 150 $5,682 155%
Lutheran Three Rivers Preferred Plus 175 $6,629 181%
Encore Work Comp In $6,819 186%
Lutheran Northwest Health Preferred $7,576 207%
Managed Health Services Exchange $7,576 207%
Workers Compensation $7,576 207%
Encore Kba Epo $9,091 249%
Encore Kba Ppo $11,364 311%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 303 S Main St, Bluffton, IN 46714
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals