CMS Price Transparency Data

Inguinal hernia repair

Facility: Holland Community Hospital

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $811
Cash Discount Price: $540
vs. Medicare Baseline: 0.22x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at Holland Community Hospital is $811. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $540. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.22x the Medicare baseline. Located in 602 Michigan Ave, Holland, MI.

Cash / Self-Pay

$540

Average discount available for prompt cash payment at this facility.

Insurance Median

$811

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: $540 (15%)

Insurance Median: $811 (22%)

Cash: $540 (15% of Medicare)

Ins. Median: $811 (22% 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
Nomi Health - All Plans	$84	2%
Life Circles-All Plans	$476	13%
Health Alliance Mcr Adv	$501	14%
Ph Mcr Adv	$501	14%
UnitedHealthcare	$501 - $1,744	14%
Va Ccn - All Plans	$501	14%
Aetna	$516 - $811	14%
Longevity Health Plan-All Plans	$541	15%
First Health-All Plans	$652	18%
Benefit Source Inc-All Plans	$720	20%
Blue Care Network - All Plans	$794	22%
Multiplan - All Plans	$810	22%
Cofinity -All Plans	$811	22%
Blue Cross Blue Shield	$849	23%
Cigna	$924	25%
Priority Health - All Other Plans	$967	26%
Asr - All Plans	$1,103	30%
Health Alliance Ahl - All Other Plans	$1,103	30%
Health Alliance Hmo	$1,103	30%
Sisco-All Other Plans	$1,156	32%
Meridian Mcaid Profee Only-All Plans	$1,744	48%
Molina Mcaid - All Plans	$1,744	48%
Ph Mcaid	$1,744	48%
Sisco Epi	$7,020	192%

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 $540.
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 Holland Community Hospital 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.