CMS Price Transparency Data

Inguinal hernia repair

Facility: University Medical Center of Princeton at Plainsboro

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $6,292
  • Cash Discount Price: $12,326
  • vs. Medicare Baseline: 1.72x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at University Medical Center of Princeton at Plainsboro is $6,292. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $12,326. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 1.72x the Medicare baseline. Located in One-Five Plainsboro Road, Plainsboro, NJ.
Cash / Self-Pay
$12,326

Average discount available for prompt cash payment at this facility.

Insurance Median
$6,292

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: $12,326 (337%)
Insurance Median: $6,292 (172%)
Cash: $12,326 (337% of Medicare)
Ins. Median: $6,292 (172% 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 $1,136 - $10,268 31%
Medicaid / KanCare $1,136 - $12,326 31%
Charity Care $1,154 32%
Wellcare $1,250 34%
Princeton Theological Seminary $1,431 39%
Private Healthcare Systems $1,800 49%
Cigna $2,015 - $12,326 55%
Horizon Nj Health $2,122 58%
Amerihealth $2,178 60%
Qualcare $2,277 - $5,544 62%
Blue Cross Blue Shield $2,476 - $9,272 68%
UnitedHealthcare $3,161 - $5,682 86%
Preferred Health Care Eliance $3,205 88%
Tricare $4,028 110%
Medicare (plans) $4,083 - $4,491 112%
Va Medical Center $4,083 112%
Clover Health Plan $4,328 118%
Humana $4,409 121%
Horizon Behavioral Health $4,621 126%
Us Family Health Plan $4,632 127%
Elap $5,798 - $7,349 159%
Beacon Health Options $6,163 168%
Magnacare $6,292 - $8,628 172%
Centivo $7,349 201%
Claim Watcher $7,349 201%
First Managed Care Option $7,958 218%
Coventry $8,628 236%
Health Net $8,628 236%
Beech Street $9,861 - $10,477 270%
Intergrated Health Plan $9,861 270%
Intergroup $9,861 270%
Penn Global Medicine Embassy Only $9,861 270%
Allied Trades $10,477 286%
Consumer Health Network $10,477 286%
Devon Health Services $10,477 286%
Ie Shaffer $10,477 286%
Total Care Network $10,477 286%
Tri-State $10,477 286%
Commercial Other $12,326 337%
Compsych $12,326 337%
Concern Plus $12,326 337%
International Pfs $12,326 337%
Life St. Francis $12,326 337%
Magellan $12,326 337%
Managed Health Network $12,326 337%
Nj Carpenters $12,326 337%
Penn Behavioral Health Corporate Services $12,326 337%
Personnel Health Program $12,326 337%
United Behavioral Health $12,326 337%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One-Five Plainsboro Road, Plainsboro, NJ 08536
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals