CMS Price Transparency Data

Inguinal hernia repair

Facility: Dukes Memorial Hospital

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $676
  • Cash Discount Price: $939
  • vs. Medicare Baseline: 0.18x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Dukes Memorial Hospital is $676. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $939. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.18x the Medicare baseline. Located in 275 W 12Th St, Peru, IN.
Cash / Self-Pay
$939

Average discount available for prompt cash payment at this facility.

Insurance Median
$676

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: $939 (26%)
Insurance Median: $676 (18%)
Cash: $939 (26% of Medicare)
Ins. Median: $676 (18% 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
Department Of Veterans Affairs $91 - $10,018 2%
Tricare $91 - $10,018 2%
Blue Cross Blue Shield $96 - $17,315 3%
Humana $96 - $10,649 3%
Iu Health Plan $96 - $10,649 3%
Managed Health Services $96 - $21,644 3%
Medicare (plans) $96 - $10,649 3%
UnitedHealthcare $96 - $26,622 3%
Aetna $98 - $25,756 3%
Node Devoted Health Mcr Adv $98 - $10,862 3%
Node Va $98 - $10,822 3%
In Dept Of Correction $102 - $11,255 3%
Miami County Sheriffs Department $102 - $11,255 3%
Node Pphp Mcr Adv $103 - $11,363 3%
Lutheran Advanced Network $147 - $16,233 4%
Lutheran Three Rivers Preferred Plus 150 $147 - $16,233 4%
Node Lutheran Preferred Fixed 2 $147 - $16,233 4%
Align Network $156 - $17,315 4%
Lutheran Preferred $156 - $43,288 4%
Lutheran Three Rivers Preferred Plus 175 $171 - $18,938 5%
Encore Work Comp In $176 - $19,480 5%
Prime Health Services $176 - $40,582 5%
Partners Direct Health Llc $186 - $20,562 5%
Lutheran Northwest Health Preferred $196 - $21,644 5%
Three Rivers Preferred Plus $196 - $1,394 5%
Work Comp $196 - $21,644 5%
Physicians Health Plan $197 - $25,226 5%
Cigna $207 - $54,110 6%
Three Rivers Preferred $220 - $3,486 6%
Php Freedom $226 - $24,983 6%
Encore Kba Epo $235 - $25,973 6%
Amish Aid $244 - $27,055 7%
Encore Ppo $244 - $27,055 7%
Self Pay $244 - $27,055 7%
Sagamore Health Network $271 - $29,977 7%
Encore Kba Ppo $293 - $32,466 8%
Consumer Life $303 - $33,548 8%
First Health $391 - $43,288 11%
Multiplan $396 - $43,829 11%
Encore Health Network $401 - $44,370 11%
Advantage Health Solutions $406 - $44,911 11%
Encore $440 - $48,699 12%
One Call Wc $460 13%
Veterans Eval Services $467 13%
Us Department Of Labor $924 25%
Caresource $1,749 - $2,274 48%
Medicaid / KanCare $2,274 62%
Mhs $2,274 62%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 275 W 12Th St, Peru, IN 46970
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Critical Access Hospitals