CMS Price Transparency Data

Inguinal hernia repair

Facility: Trinity Health Muskegon Hospital

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $4,891
  • Cash Discount Price: $25,725
  • vs. Medicare Baseline: 1.34x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Trinity Health Muskegon Hospital is $4,891. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $25,725. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 1.34x the Medicare baseline. Located in 1500 E Sherman Blvd, Muskegon, MI.
Cash / Self-Pay
$25,725

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,891

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: $25,725 (703%)
Insurance Median: $4,891 (134%)
Cash: $25,725 (703% of Medicare)
Ins. Median: $4,891 (134% 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
U Of M Health Plan $1,140 31%
Blue Cross Blue Shield $2,000 - $6,349 55%
Medicaid / KanCare $2,000 - $3,457 55%
Access Health $2,675 - $4,535 73%
Aetna $3,744 - $6,349 102%
Blue Care Network Advantage $3,744 - $6,349 102%
Medicare (plans) $3,744 - $6,349 102%
Align Senior Care $3,821 - $6,479 104%
Correctional Recovery $3,821 - $6,479 104%
Heartland Hospice $3,821 - $6,479 104%
Hospice Harbor Hospice $3,821 - $6,479 104%
UnitedHealthcare $3,935 - $6,673 108%
Longevity Ipa Of Michigan Llc Health Plan Isnp $4,306 - $7,301 118%
Bcn Domestic $4,432 - $5,540 121%
Blue Benefit Administrators Of Massachusetts $4,432 - $5,540 121%
Blue Care Network $4,432 - $5,540 121%
Blue Distinction Transplant $4,432 - $5,540 121%
Blue Shield - Ca $4,432 - $5,540 121%
Blue Shield - Id (Regence) $4,432 - $5,540 121%
Blue Shield - Ny Highmark Northeastern $4,432 - $5,540 121%
Blue Shield - Ny Highmark Western $4,432 - $5,540 121%
Blue Shield - Pa (Highmark) $4,432 - $5,540 121%
Blue Shield - Wa (Regence) $4,432 - $5,540 121%
Health Choices $4,432 - $5,540 121%
Kaiser Domestic $4,432 - $5,540 121%
Oscar $4,891 - $8,293 134%
Molina Marketplace $4,967 - $8,422 136%
Vitalcore $5,922 - $10,042 162%
Wellpath $5,922 - $10,042 162%
Priority Health $6,547 - $14,649 179%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1500 E Sherman Blvd, Muskegon, MI 49441
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals