CMS Price Transparency Data

Inguinal hernia repair

Facility: Chilton Medical Center

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $4,095
  • Cash Discount Price: $4,709
  • vs. Medicare Baseline: 1.12x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Chilton Medical Center is $4,095. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,709. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 1.12x the Medicare baseline. Located in 97 West Parkway, Pompton Plains, NJ.
Cash / Self-Pay
$4,709

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,095

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: $4,709 (129%)
Insurance Median: $4,095 (112%)
Cash: $4,709 (129% of Medicare)
Ins. Median: $4,095 (112% 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
Wtc Health Program [5273] $1,063 29%
Horizon Nj Health [5021] $2,264 62%
Karen Ann Quinlan [5285] $4,095 112%
Highmark Wholecare Health Plan Ip Splits [5464] $4,095 112%
Tricare $4,095 112%
Highmark Wholecare Health Plan [5413] $4,095 112%
Claim Watcher/Homestead [5488] $4,095 112%
Blue Cross Blue Shield $4,095 112%
Claimdoc [5434] $4,095 112%
Us Family Health Plan [5258] $4,095 112%
Amerihealth Medigap [5049] $4,095 112%
Medicare (plans) $4,095 - $4,238 112%
Wellcare Health Plans [5269] $4,095 112%
Sedgwick Wtc Health Program Wc [5514] $4,095 112%
Wellcare Health Plans Ip Splits [5475] $4,095 112%
Aetna $4,095 - $5,733 112%
Ambetter / Centene $4,095 112%
Wellcare Behavioral Health [5335] $4,095 112%
UPMC [5455] $4,095 112%
Champva [5354] $4,095 112%
Amerihealth Administrators Supplemental [5512] $4,095 112%
VA Community Care Network [5403] $4,095 112%
Luminare Health AHS Retiree [5013] $4,095 112%
Cigna $4,095 112%
Fairos [5491] $4,095 112%
Amerihealth Caritas Vip Care Ip Splits [5460] $4,136 113%
Amerihealth Caritas Vip Care [5313] $4,136 113%
Kindred Giralda Hospital [5341] $4,504 123%
Amerihealth [5008] $5,753 - $7,075 157%
Specialty Imaging [5433] $6,907 189%
Cosmetic Surgery/Lap Band/Gastric Bypass [5289] $6,907 189%
Medicaid / KanCare $6,907 189%
Medlogix/Consumer Health Network Pip (Chn) [5414] $8,983 246%
Zurich No Fault [5274] $8,983 246%
Travelers No Fault [5249] $8,983 246%
Geico No Fault [5120] $8,983 246%
Progressive No Fault [5229] $8,983 246%
Hanover No Fault [5129] $8,983 246%
State Farm No Fault [5241] $8,983 246%
Esurance No Fault [5105] $8,983 246%
Nj Manufacturers No Fault [5203] $8,983 246%
High Point No Fault [5146] $8,983 246%
Allstate [5047] $8,983 246%
Plymouth Rock Assurance No Fault [5222] $8,983 246%
Liberty Mutual No Fault [5173] $8,983 246%
Usaa No Fault [5260] $8,983 246%
Kessler Foundation [5532] $12,000 328%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 97 West Parkway, Pompton Plains, NJ 07444
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals