CMS Price Transparency Data

Inguinal hernia repair

Facility: Covenant Medical Center

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $720
Cash Discount Price: $720
vs. Medicare Baseline: 0.20x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at Covenant Medical Center is $720. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $720. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.20x the Medicare baseline. Located in 1447 N Harrison, Saginaw, MI.

Cash / Self-Pay

$720

Average discount available for prompt cash payment at this facility.

Insurance Median

$720

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: $720 (20%)

Insurance Median: $720 (20%)

Cash: $720 (20% of Medicare)

Ins. Median: $720 (20% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Health Advantage Mclaren Employee	$423 - $502	12%
Priority Health E	$433 - $513	12%
Aetna	$501 - $3,658	14%
Blue Cross Blue Shield	$501 - $4,468	14%
Health Alliance Plan Of Michigan	$501 - $7,060	14%
Healthy Michigan Mclaren	$501 - $1,913	14%
Healthy Michigan Meridian	$501 - $1,913	14%
Healthy Michigan Molina	$501 - $1,913	14%
Healthy Michigan Priority Health	$501 - $1,913	14%
Humana	$501 - $3,658	14%
Mclaren Advantage	$501 - $3,658	14%
Molina Healthplan	$501 - $3,658	14%
Physicians Health Plan Advantage/Advantage Plus	$501 - $3,658	14%
Priority Health	$501 - $3,658	14%
Physicians Health Plan	$518 - $614	14%
Mclaren Health Advantage	$531 - $796	15%
Meritain Health	$720 - $854	20%
Multiplan	$847 - $1,004	23%
Blue Care Network	$849 - $4,468	23%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $720.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 49505.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Covenant Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 49505.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.