CMS Price Transparency Data

Inguinal hernia repair

Facility: Saint Joseph Regional Medical Center - Plymouth

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $230
  • Cash Discount Price: $1,157
  • vs. Medicare Baseline: 0.06x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Saint Joseph Regional Medical Center - Plymouth is $230. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,157. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.06x the Medicare baseline. Located in 1915 Lake Ave, Plymouth, IN.
Cash / Self-Pay
$1,157

Average discount available for prompt cash payment at this facility.

Insurance Median
$230

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: $1,157 (32%)
Insurance Median: $230 (6%)
Cash: $1,157 (32% of Medicare)
Ins. Median: $230 (6% 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

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Bcn Domestic $52 - $489 1%
Blue Benefit Administrators Of Massachusetts $52 - $22,677 1%
Blue Care Network $52 - $22,677 1%
Blue Cross Blue Shield $52 - $22,677 1%
Blue Distinction Transplant $52 - $22,677 1%
Blue Shield - Ca $52 - $22,677 1%
Blue Shield - Id (Regence) $52 - $22,677 1%
Blue Shield - Ny Highmark Northeastern $52 - $22,677 1%
Blue Shield - Ny Highmark Western $52 - $22,677 1%
Blue Shield - Pa (Highmark) $52 - $22,677 1%
Blue Shield - Wa (Regence) $52 - $22,677 1%
Health Choices $52 - $489 1%
Kaiser Domestic $52 - $489 1%
Pre-Employment $52 - $489 1%
Wc Domestic $52 - $489 1%
Aetna $54 - $9,956 1%
Align Senior Care $54 - $338 1%
Ally Align Care Adv $54 - $338 1%
American Health Advantage Of Idaho $54 - $338 1%
American Health Plan $54 - $338 1%
Aurora Special Needs $54 - $338 1%
Blue Care Network Advantage $54 - $338 1%
Blue Shield - De (Highmark) Medciare Advantage $54 - $338 1%
Care Dimensions $54 - $338 1%
Care Improvement Plus $54 - $338 1%
Care Resources Pace $54 - $338 1%
Careplus Health Plans $54 - $338 1%
Cca - Zing Health $54 - $338 1%
Cca Senior Care Options $54 - $338 1%
Central Valley Medical Services Corp Pace $54 - $338 1%
Champion Health Plan Mcr Advantage $54 - $338 1%
Cigna $54 - $832 1%
Clear Spring Health $54 - $338 1%
Clover Health $54 - $338 1%
Commonwealth Care Alliance $54 - $338 1%
Community Pace At Home $54 - $338 1%
Eddy Senior Care-Pace $54 - $338 1%
Eddy Seniorcare Pace $54 - $338 1%
Elementcare $54 - $338 1%
Evercare $54 - $338 1%
Everence $54 - $338 1%
Gateway Health Plan $54 - $338 1%
Genesys Pace Of Genesee County $54 - $338 1%
Georgia Health Advantage $54 - $338 1%
Gold Advantage $54 - $338 1%
Gpa Croell Redi Mix $54 - $338 1%
Health America Advantra $54 - $338 1%
Highmark Health Options Dual Plan $54 - $338 1%
Hope Select Pace $54 - $338 1%
Horizon Nj Total Care $54 - $338 1%
Hudson Headwaters Pace $54 - $338 1%
Humana $54 - $351 1%
Huron Valley Pace $54 - $338 1%
Innovative Integrated Health Community Plans $54 - $338 1%
Iowa Health Advantage $54 - $338 1%
Johns Hopkins Advantage Md $54 - $338 1%
Lasso Healthcare Msa $54 - $338 1%
Life St Marys Pace $54 - $338 1%
Lifecircles Pace $54 - $338 1%
Longevity Health Plan $54 - $338 1%
Longevity Ipa Of Michigan Llc Health Plan Isnp $54 - $338 1%
Martins Point Generations Advantage $54 - $338 1%
Mass General Brigham Mcr Adv $54 - $338 1%
Medicare (plans) $54 - $6,552 1%
Medipak Advantage $54 - $338 1%
Mercy Life $54 - $338 1%
Mercyone Cedar Valley $54 - $338 1%
Meridian Complete $54 - $6,423 1%
Michigan Complete Health $54 - $338 1%
Nascentia Health Plus $54 - $338 1%
New Centry Health Careplus $54 - $338 1%
Osu Prime Care Advantage $54 - $338 1%
Pace Cny $54 - $338 1%
Pace Iowa Immanuel Pathways $54 - $338 1%
Pace Of Southwest Michigan $54 - $351 1%
Pace Southeast $54 - $338 1%
Pace-Trinity Health $54 - $6,423 1%
Peak Pace Solutions $54 - $338 1%
Perennial Advantage $54 - $338 1%
Preferred Care Partners $54 - $338 1%
Presbyterian Senior Plan $54 - $338 1%
Provider Partners Health Plan Of Illinois $54 - $338 1%
Pruitthealth Premier $54 - $338 1%
Reliance Community Care Partners Care Resources Pace $54 - $338 1%
Rx Allwin $54 - $338 1%
Rx Grane Grnmedd $54 - $338 1%
Rx Retiree Rx Care $54 - $338 1%
Scan Health Plan Mcr Ipa Meritage Oon $54 - $338 1%
Secure Horizons Ma Pffs $54 - $338 1%
Serenity Pace $54 - $338 1%
Siouxland Pace $54 - $338 1%
Solis Health Plans $54 - $338 1%
Sunnyview-Pace Finance Dept $54 - $338 1%
Texan Plus $54 - $338 1%
The Health Plan $54 - $338 1%
Thome Pace $54 - $338 1%
Todays Options $54 - $338 1%
Tribute Health Plans $54 - $338 1%
Um Health Advantage $54 - $338 1%
Union Health Service $54 - $338 1%
UnitedHealthcare $54 - $6,420 1%
Welbe Health $54 - $338 1%
Wellmed $54 - $338 1%
Ameriben $55 - $517 2%
Veterans Administration $55 - $345 2%
Albany County Correctional Facility $56 - $351 2%
Ambetter / Centene $56 - $351 2%
Amish Mennonite $56 - $351 2%
Ascension St. Vincent Public Safety Medical $56 - $351 2%
Bcccp-Michigan $56 - $351 2%
Bccp $56 - $351 2%
Bmc Healthnet $56 - $351 2%
Breast Grant-Connecticut $56 - $351 2%
Broward County Dept Of Health $56 - $351 2%
California Health And Wellness $56 - $351 2%
Cardinal Innovations Lme $56 - $351 2%
Care Connections Of Northern Iowa $56 - $351 2%
Care Oregon Ohp $56 - $351 2%
Cencal Health Plan $56 - $351 2%
Cenpatico $56 - $351 2%
Champva $56 - $351 2%
Chhuny $56 - $351 2%
Childrens Comm Health Plan $56 - $351 2%
Childrens Medical Services Title 19 $56 - $351 2%
City Of Philadelphia $56 - $351 2%
Cmh Allegan County $56 - $351 2%
Cmh Ausable Valley $56 - $351 2%
Cmh Barry County $56 - $351 2%
Cmh Bay-Arenac County $56 - $351 2%
Cmh Berrien County $56 - $351 2%
Cmh Cass County $56 - $351 2%
Cmh Central Mi County $56 - $351 2%
Cmh Clinton-Eaton-Ingham County $56 - $351 2%
Cmh Detroit Wayne Integrated Health Network $56 - $351 2%
Cmh Genesee County $56 - $351 2%
Cmh Ionia County $56 - $351 2%
Cmh Jackson County/Lifeways $56 - $351 2%
Cmh Kalamazoo $56 - $351 2%
Cmh Kent County $56 - $351 2%
Cmh Lenawee County $56 - $351 2%
Cmh Livingston County $56 - $351 2%
Cmh Macomb $56 - $351 2%
Cmh Misc $56 - $351 2%
Cmh Monroe County $56 - $351 2%
Cmh Montcalm County $56 - $351 2%
Cmh Muskegon County $56 - $351 2%
Cmh Newaygo County $56 - $351 2%
Cmh North Country $56 - $351 2%
Cmh Northern Lakes County $56 - $351 2%
Cmh Oakland County $56 - $351 2%
Cmh Ottawa County $56 - $351 2%
Cmh Van Buren County $56 - $351 2%
Cmh Washtenaw County $56 - $351 2%
Cmh Wayne County/Carelink $56 - $351 2%
Cmh Wayne Cty/Com Liv Svcs $56 - $351 2%
Cmh West Mi County $56 - $351 2%
Community Benefit Health $56 - $351 2%
Community Care Behavorial Health $56 - $351 2%
Community Care Partners $56 - $351 2%
Community Health Choice $56 - $351 2%
Connections Csp $56 - $351 2%
County Coroner $56 - $6,680 2%
County Funding Generic $56 - $351 2%
Covid19 Hrsa Uninsured Testing And Treatment Fund $56 - $351 2%
Dean Wi Badgercare $56 - $351 2%
Delaware County Department Of Health $56 - $351 2%
Delaware First Health $56 - $351 2%
Delta Dental Nj $56 - $351 2%
Dph Tb Program $56 - $351 2%
Dscc $56 - $351 2%
Eastpointe Lme $56 - $351 2%
Family Health Network $56 - $351 2%
Freedom First Healthcare $56 - $351 2%
Fresno County Ccs $56 - $351 2%
Ghc Scw Wi Badgercare $56 - $351 2%
Harbor Health $56 - $351 2%
Health Safety Net $56 - $351 2%
Healthy Blue Ne $56 - $351 2%
Hennepin Health $56 - $351 2%
Id County Ada $56 - $351 2%
Id County Canyon $56 - $351 2%
Id County Cat Fund $56 - $351 2%
Id County Other $56 - $351 2%
Id County Payette $56 - $351 2%
Idaho Dept Health And Wellfare $56 - $351 2%
Idaho Womens Health Check $56 - $351 2%
Indiana Breast Cervical Cancer $56 - $351 2%
Inland Empire Health Plan $56 - $351 2%
Intercommunity Health Ohp $56 - $351 2%
Iowa Total Care $56 - $351 2%
Jai Medical System $56 - $351 2%
Kern Family Health Plan $56 - $351 2%
Keystone First $56 - $351 2%
Keystone First Chip $56 - $351 2%
La Care Health Plan $56 - $351 2%
Lakeland Care Inc $56 - $351 2%
Managed Health Services - Indiana $56 - $3,410 2%
Maryland Breast & Cervical Program $56 - $351 2%
Maryland Healthy Smiles - Scion Dental $56 - $351 2%
Maryland Physicians Care $56 - $351 2%
Massachusetts Behavioral Health Partnership $56 - $351 2%
Mdwise $56 - $3,410 2%
Medi-Cal $56 - $351 2%
Medi-Cal Healthnet $56 - $351 2%
Medicaid / KanCare $56 - $3,410 2%
Medstar Dc Healthy Family $56 - $351 2%
Medstar Md Health Choice $56 - $351 2%
Mo Home State Health Plan $56 - $351 2%
Molina Centennial Care $56 - $351 2%
Nascentia Health Options $56 - $351 2%
Nebraska Total Care $56 - $351 2%
New York Cancer Services Program $56 - $351 2%
Nextlevel Health $56 - $351 2%
Oregon Screenwise $56 - $351 2%
Paramount Advantage $56 - $351 2%
Parkland Community Health Plan $56 - $351 2%
Partners Behavioral Lme $56 - $351 2%
Peach State Healthplan $56 - $351 2%
Philadelphia County Funding $56 - $351 2%
Presbyterian Centennial Care $56 - $351 2%
Prestige Health Choice $56 - $351 2%
Priority Partners $56 - $351 2%
Robert F Sing Program $56 - $351 2%
Rx 340B Pass Along $56 - $351 2%
Rx Assistance/Rx Manufacturer Assistance 0 Copay $56 - $351 2%
Rx Medi-Cal $56 - $351 2%
Rx Meridian Rx $56 - $351 2%
Ryan White Florida Mssrp $56 - $351 2%
Sandhills Center Lme $56 - $351 2%
Screening For Life $56 - $351 2%
St Joseph County Hlth Dpt $56 - $9,635 2%
Stephenson Cty Health $56 - $351 2%
Sunshine State Health Plan $56 - $351 2%
Superior Health $56 - $351 2%
Tenncare $56 - $351 2%
Texas Children'S Health Plan $56 - $351 2%
Tricare $56 - $351 2%
Trillium Community Ohp $56 - $351 2%
Triwest Health Alliance $56 - $351 2%
Tufts Health Public Plans $56 - $351 2%
Us Family Health Plan $56 - $351 2%
Vaya Health Lme $56 - $351 2%
Veterans Eval Services $56 - $351 2%
Washtenaw Health Plan $56 - $351 2%
Wellsense Health Plan $56 - $351 2%
Wi Womens Wellness $56 - $351 2%
Provider Partners Health Plan Of Indiana $61 - $7,065 2%
Christian Brother Services $64 - $596 2%
Meritain $64 - $596 2%
Preferred One $64 - $596 2%
Geha $68 - $640 2%
Andrie Inc $69 - $345 2%
East Greenbush Central School District $69 - $345 2%
Genex Wc $69 - $345 2%
Healthsmart Workers Comp $69 - $345 2%
Jag Source $69 - $345 2%
New York State Insurance Fund $69 - $345 2%
Njm Insurance Group $69 - $345 2%
Rx Heatlhcomp $69 - $345 2%
Rx Restat $69 - $345 2%
Rx Saif Opdp Wc $69 - $345 2%
Rx Worker'S Comp $69 - $345 2%
Wc Accident Fund $69 - $345 2%
Wc Ace $69 - $345 2%
Wc Acs Federal Employees $69 - $345 2%
Wc Acuity $69 - $345 2%
Wc Advantage $69 - $345 2%
Wc Aegis $69 - $345 2%
Wc Aig $69 - $345 2%
Wc Aims $69 - $345 2%
Wc Alaska National Ins $69 - $345 2%
Wc Align Network $69 - $345 2%
Wc Allied $69 - $345 2%
Wc Am Trust N America $69 - $345 2%
Wc American Claims Mgmt $69 - $345 2%
Wc Amerisure $69 - $345 2%
Wc Amtrust $69 - $345 2%
Wc Asu Risk Mgt $69 - $345 2%
Wc Benetech $69 - $345 2%
Wc Berkley Admin $69 - $345 2%
Wc Broadspire $69 - $345 2%
Wc Broward County $69 - $345 2%
Wc Bunch & Associates $69 - $345 2%
Wc California State Comp Ins $69 - $345 2%
Wc California State Ins Fund $69 - $345 2%
Wc Capitol Area Health Consortium $69 - $345 2%
Wc Ccmsi $69 - $345 2%
Wc Chartis $69 - $345 2%
Wc Chubb $69 - $345 2%
Wc Cirma $69 - $345 2%
Wc City Of Albany $69 - $345 2%
Wc City Of Sioux City $69 - $345 2%
Wc Claims Mgmt Inc $69 - $345 2%
Wc Cna $69 - $345 2%
Wc Comp One Admin C/O Manageability $69 - $345 2%
Wc Compone Admin $69 - $345 2%
Wc Corvel $69 - $345 2%
Wc Ct Healthcare Trust $69 - $345 2%
Wc Donegal Insurance Group $69 - $345 2%
Wc Emc Insurance Company $69 - $345 2%
Wc Employee Mutual $69 - $345 2%
Wc Enablecomp $69 - $345 2%
Wc Erie $69 - $345 2%
Wc Esis $69 - $345 2%
Wc Evolutions $69 - $345 2%
Wc Fcci $69 - $345 2%
Wc Fed Ex $69 - $345 2%
Wc Federal Black Lung $69 - $345 2%
Wc Federated $69 - $345 2%
Wc Finley Occupational Health $69 - $345 2%
Wc First Agency/Occunet $69 - $345 2%
Wc Ford Motor $69 - $345 2%
Wc Fresno Unified Emp $69 - $345 2%
Wc Gallagher Bassett $69 - $345 2%
Wc General Motors $69 - $345 2%
Wc Generic $69 - $345 2%
Wc Genex Care For Ohio $69 - $345 2%
Wc Great West Casualty $69 - $345 2%
Wc Guarantee Insurance $69 - $345 2%
Wc Guard Insurance Company $69 - $345 2%
Wc Hab $69 - $345 2%
Wc Hartford $69 - $345 2%
Wc Hastings $69 - $345 2%
Wc Health Management $69 - $345 2%
Wc Heritage Summit $69 - $345 2%
Wc Hireright $69 - $345 2%
Wc Horizon $69 - $345 2%
Wc Icw Group $69 - $345 2%
Wc Idaho State Ins Fund $69 - $345 2%
Wc Intercare Insurance $69 - $345 2%
Wc Intermountain $69 - $345 2%
Wc Johns Eastern $69 - $345 2%
Wc Kemberton $69 - $345 2%
Wc Key Ins & Benefit Solutions $69 - $345 2%
Wc Liberty Mutual $69 - $345 2%
Wc Mac Risk Management $69 - $345 2%
Wc Massachusetts $69 - $345 2%
Wc Mdia $69 - $345 2%
Wc Meadowbrook Claim $69 - $345 2%
Wc Medical Administrators $69 - $345 2%
Wc Meijers $69 - $345 2%
Wc Memic $69 - $345 2%
Wc Mercy Workcare $69 - $345 2%
Wc Michigan $69 - $345 2%
Wc Michigan Millers Mutual $69 - $345 2%
Wc Mitchell Frankenmuth $69 - $345 2%
Wc Mra $69 - $345 2%
Wc Nationwide $69 - $345 2%
Wc Nca Comp $69 - $345 2%
Wc New York $69 - $345 2%
Wc New York Special Funds $69 - $345 2%
Wc North American Rishces $69 - $345 2%
Wc Northeast Health $69 - $345 2%
Wc Notre Dame $69 - $345 2%
Wc Novanet $69 - $345 2%
Wc O'Hara Corp $69 - $345 2%
Wc Occ Health Allen $69 - $345 2%
Wc Ohio Bureau $69 - $345 2%
Wc One Call Medical $69 - $345 2%
Wc Paradigm $69 - $345 2%
Wc Peerless $69 - $345 2%
Wc Pma $69 - $345 2%
Wc Praxis Health Network $69 - $345 2%
Wc Price Chopper $69 - $345 2%
Wc Procura Management $69 - $345 2%
Wc Qualcare $69 - $345 2%
Wc Quiktrip $69 - $345 2%
Wc Reny Company $69 - $345 2%
Wc Rev Claims $69 - $345 2%
Wc Risico $69 - $345 2%
Wc Rural Mutual $69 - $345 2%
Wc Saif Oregon $69 - $345 2%
Wc Secura $69 - $345 2%
Wc Sedgwick $69 - $345 2%
Wc Sentry $69 - $345 2%
Wc Sheakley Unicomp $69 - $345 2%
Wc Smile Lodge $69 - $345 2%
Wc Society $69 - $345 2%
Wc Srs $69 - $345 2%
Wc Taconic (Mro) $69 - $345 2%
Wc Taconic Farms $69 - $345 2%
Wc Travelers $69 - $345 2%
Wc Triad Group $69 - $345 2%
Wc Tristar $69 - $345 2%
Wc Troy Ny $69 - $345 2%
Wc Tyson $69 - $345 2%
Wc Unified Health Services $69 - $345 2%
Wc United Heartland $69 - $345 2%
Wc Us Dept Of Labor $69 - $345 2%
Wc Velocity $69 - $345 2%
Wc Walmart $69 - $345 2%
Wc West Bend $69 - $345 2%
Wc West Bend Mutual/Argent $69 - $345 2%
Wc Winnebago Industries $69 - $345 2%
Wc Yankee Trails $69 - $345 2%
Wc York Risk $69 - $345 2%
Wc Zenith $69 - $345 2%
Wc Zurich $69 - $345 2%
Caresource $72 - $9,956 2%
Community Health Alliance $82 - $771 2%
Allied Benefit Systems $83 - $12,204 2%
Auxiant $83 - $13,810 2%
Benefit Administrative Systems,Llc $83 - $782 2%
Custom Design Benefits $83 - $13,810 2%
Encore Health $83 - $832 2%
Key Benefit Administrator $83 - $13,810 2%
Luminare Health (Detroit) $83 - $782 2%
Physicians Health Plan Northern Indiana Health Insurance $83 - $19,398 2%
Sagamore Health Network $89 - $832 2%
Signature Care $89 - $832 2%
Phcs $167 - $2,198 5%
Plain Church Group $185 - $2,442 5%
Wc Encore Health Network $578 - $1,832 16%
Siho Insurance Services $6,061 - $10,277 166%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1915 Lake Ave, Plymouth, IN 46563
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals