CMS Price Transparency Data

Inguinal hernia repair

Facility: Raritan Bay Medical Center

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $4,927
  • Cash Discount Price: $3,910
  • vs. Medicare Baseline: 1.35x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Raritan Bay Medical Center is $4,927. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,910. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 1.35x the Medicare baseline. Located in 530 New Brunswick Ave, Perth Amboy, NJ.
Cash / Self-Pay
$3,910

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,927

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: $3,910 (107%)
Insurance Median: $4,927 (135%)
Cash: $3,910 (107% of Medicare)
Ins. Median: $4,927 (135% 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
Horizon $506 - $9,102 14%
Karna $1,122 31%
UnitedHealthcare $1,189 - $13,893 33%
Aetna $1,287 - $8,419 35%
Clover $1,742 48%
Seoul Medical Group $2,004 55%
Activecare First McO $2,915 80%
Blue Cross Blue Shield $3,910 107%
Vaccn $3,910 107%
Wellcare $3,910 107%
United Community/Americhoice $4,105 112%
Amerigroup $4,183 114%
Cigna $4,196 - $7,744 115%
Amerihealth $4,611 - $5,152 126%
Qualcare $5,366 - $8,518 147%
Bergen Risk $7,260 198%
Multiplan - PHCS $8,228 225%
Brighton Health Plan $9,933 272%
Oxford $11,028 301%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 530 New Brunswick Ave, Perth Amboy, NJ 08861
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals