CMS Price Transparency Data

Inguinal hernia repair

Facility: Merit Health River Oaks

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $5,972
  • Cash Discount Price: $16,208
  • vs. Medicare Baseline: 1.63x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Merit Health River Oaks is $5,972. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $16,208. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 1.63x the Medicare baseline. Located in 1030 River Oaks Drive, Flowood, MS.
Cash / Self-Pay
$16,208

Average discount available for prompt cash payment at this facility.

Insurance Median
$5,972

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: $16,208 (443%)
Insurance Median: $5,972 (163%)
Cash: $16,208 (443% of Medicare)
Ins. Median: $5,972 (163% 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
Veterans Eval Services $472 13%
Medicaid / KanCare $2,689 - $13,731 74%
UnitedHealthcare $2,689 - $24,041 74%
Magnolia Mcd Chip $2,716 74%
Caresource Truecare $2,743 75%
Molina Chip $2,904 79%
Humana $3,181 87%
Medicare (plans) $3,181 87%
Node First Choice Shared Health Of Ms Mcr Adv $3,181 87%
Node Vantage Health Mcr Adv $3,181 87%
Node Hospice Non Par Agree $3,233 88%
Node Va $3,233 88%
Molina $3,244 89%
Node Devoted Health Mcr Adv $3,244 89%
Node First Choice American Health Mcr Adv $3,244 89%
Aetna $3,276 - $63,030 90%
Node First Choice Wellcare Mcr Adv $3,297 90%
Node Healthy Mississippi Mcr Adv $3,556 97%
Node Us Dept Of Labor $4,041 110%
First Choice Preferred $4,849 133%
Node First Choice Occunet $4,849 133%
Molina Exchange $5,002 137%
Advanced Health Systems $5,386 147%
Node First Choice Seven Corners $5,495 150%
Magnolia Exchange $5,657 155%
Ms Work Comp $6,349 174%
Prime Health Wc $6,349 174%
Blue Cross Blue Shield $6,459 177%
First Choice Lgp $7,047 193%
Vantage Health Commercial $7,273 199%
Ms Dept Of Rehabilitation Services $7,381 202%
Tricare $9,793 268%
Node Champva $10,309 282%
Cigna $17,918 490%
Self Pay $19,809 542%
Trimed Billing Solutions $27,013 738%
Ms State Hospital Of Whitfield Ms $34,216 935%
First Choice Standard $41,419 1132%
First Choice Coventry $46,822 1280%
First Choice Mpcn Standard $49,523 1354%
First Choice Ppo Plus $49,523 1354%
Phcs $54,025 1477%
First Choice Stratose $72,034 1969%
Prime Health Services $72,034 1969%
American Health Group $76,536 2092%
Beech Street $76,536 2092%
Benefit Administration Services $76,536 2092%
Benefit Management Systems $76,536 2092%
Citizens State Bank Inc $76,536 2092%
Formost $76,536 2092%
Usa Mco $76,536 2092%
One Health Plan $81,038 2215%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1030 River Oaks Drive, Flowood, MS 39232
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals