CMS Price Transparency Data

Inguinal hernia repair

Facility: Lake Huron Medical Center

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $3,550
  • Cash Discount Price: $3,550
  • vs. Medicare Baseline: 0.97x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Lake Huron Medical Center is $3,550. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,550. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.97x the Medicare baseline. Located in 2601 Electric Avenue, Port Huron, MI.
Cash / Self-Pay
$3,550

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,550

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: $3,550 (97%)
Insurance Median: $3,550 (97%)
Cash: $3,550 (97% of Medicare)
Ins. Median: $3,550 (97% 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
Mclaren Health Plan $1,904 - $3,550 52%
Medicaid / KanCare $1,904 52%
Priority Health $1,904 52%
Aetna $1,942 - $3,621 53%
Blue Cross Blue Shield $3,550 - $4,614 97%
Honest Hmo $3,550 97%
Medicare (plans) $3,550 97%
Reliance Hmo $3,550 97%
Sunrise $3,550 97%
Tricare $3,550 97%
Zing $3,728 102%
Employer Direct Healthcare $4,970 136%
Naphcare $5,503 150%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2601 Electric Avenue, Port Huron, MI 48060
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals