CMS Price Transparency Data

Inguinal hernia repair

Facility: Sparrow Ionia Hospital

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $548
  • Cash Discount Price: $265
  • vs. Medicare Baseline: 0.15x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Sparrow Ionia Hospital is $548. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $265. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.15x the Medicare baseline. Located in 3565 S State Road, Ionia, MI.
Cash / Self-Pay
$265

Average discount available for prompt cash payment at this facility.

Insurance Median
$548

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: $265 (7%)
Insurance Median: $548 (15%)
Cash: $265 (7% of Medicare)
Ins. Median: $548 (15% 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
Priority $79 - $651 2%
Blue Cross Blue Shield $80 - $849 2%
UnitedHealthcare $98 - $814 3%
Cigna $101 - $840 3%
Great West Healthcare $101 - $840 3%
Asr $102 - $849 3%
Blue Care Network $102 - $849 3%
Health Alliance Plan $102 - $849 3%
Cofinity $104 - $859 3%
Humana $104 - $859 3%
Mclaren Commercial $114 - $945 3%
Medicaid / KanCare $340 9%
Aetna $507 - $796 14%
Medicare (plans) $509 - $622 14%
Covenant Advantage $586 16%
Medigold $586 16%
Senior Community Care $586 16%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3565 S State Road, Ionia, MI 48846
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals