CMS Price Transparency Data

Inguinal hernia repair

Facility: Essentia Health

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $3,529
  • Cash Discount Price: $3,578
  • vs. Medicare Baseline: 0.96x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Essentia Health is $3,529. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,578. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.96x the Medicare baseline. Located in 3000 32Nd Ave South, Fargo, ND.
Cash / Self-Pay
$3,578

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,529

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: $3,578 (98%)
Insurance Median: $3,529 (96%)
Cash: $3,578 (98% of Medicare)
Ins. Median: $3,529 (96% 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
Medica Access $1,279 35%
Healthpartners Care Pmap $1,856 51%
Sanford Health Plan $2,046 - $6,249 56%
Blue Cross Blue Shield $2,147 - $7,905 59%
Medica $2,643 - $2,939 72%
Medica Uplan $2,643 72%
Medica Choice $3,025 83%
Ucare $3,139 86%
Cigna $3,197 87%
Healthpartners $3,197 87%
Healthpartners Pcc Prime $3,197 87%
Primewest $3,336 91%
Wea $3,435 - $3,674 94%
Advocare/Security Health $3,529 96%
Freedom Blue Ppo $3,529 96%
Healthpartners Care Msho / Mcr Adv $3,529 96%
Imcare Msho Pcc Prime $3,529 96%
Imcare Msho Ref Req $3,529 96%
Itasca Med Care $3,529 96%
Medica Advantage Solutions $3,529 96%
Medica Msho/Dual Solutions $3,529 96%
Medica Prime Solution Group $3,529 96%
Medicare (plans) $3,529 96%
Nd Va Administration $3,529 96%
Platinum Blue/Vantage Blue $3,529 96%
Primewest Msho $3,529 96%
Secure Blue Msho $3,529 96%
Ubh Cost Plan $3,529 96%
Ubh Msho $3,529 96%
Ucare Msho $3,529 96%
UnitedHealthcare $3,529 - $3,802 96%
America'S Ppo $3,698 101%
Wps $3,960 - $4,008 108%
Aetna $4,055 111%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3000 32Nd Ave South, Fargo, ND 58104
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals