CMS Price Transparency Data

Inguinal hernia repair

Facility: Harlan County Health System

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $1,770
  • Cash Discount Price: $2,207
  • vs. Medicare Baseline: 0.48x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Harlan County Health System is $1,770. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,207. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.48x the Medicare baseline. Located in 717 Brown St, Alma, NE.
Cash / Self-Pay
$2,207

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,770

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: $2,207 (60%)
Insurance Median: $1,770 (48%)
Cash: $2,207 (60% of Medicare)
Ins. Median: $1,770 (48% 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
Aetna $452 - $2,295 12%
Medica Chi Health $452 - $2,983 12%
Medica Mcr Adv $452 - $1,770 12%
Medica Prime Solution $452 - $1,770 12%
Tricare $452 - $2,197 12%
UnitedHealthcare $452 - $3,147 12%
Great Plains Mcr Adv-All Plans $474 - $2,306 13%
Medica Ifb Aco $819 - $3,147 22%
Blue Cross Blue Shield $862 - $3,147 24%
Medica Chi Aco - All Other Plans $862 - $2,983 24%
Medica Choice $903 - $2,983 25%
Medica Ifb Open Access $1,047 - $3,147 29%
Phcs/Multiplan-All Plans $1,350 - $3,213 37%
Ohara Llc Wc- All Plans $2,126 - $3,115 58%
Humana $2,197 60%
Ambetter / Centene $2,283 62%
Healthy Blue Mcaid-All Plans $2,350 64%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 717 Brown St, Alma, NE 68920
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals