CMS Price Transparency Data

Inguinal hernia repair

Facility: Robert Wood Johnson University Hospital - Somerset

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $5,854
  • Cash Discount Price: $6,311
  • vs. Medicare Baseline: 1.60x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Robert Wood Johnson University Hospital - Somerset is $5,854. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,311. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 1.60x the Medicare baseline. Located in 110 Rehill Ave, Somerville, NJ.
Cash / Self-Pay
$6,311

Average discount available for prompt cash payment at this facility.

Insurance Median
$5,854

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: $6,311 (173%)
Insurance Median: $5,854 (160%)
Cash: $6,311 (173% of Medicare)
Ins. Median: $5,854 (160% 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
Wellpoint $284 - $3,857 8%
Blue Cross Blue Shield $306 - $3,857 8%
Humana $3,857 105%
Aetna $3,857 - $7,991 105%
Fidelis Care $3,857 105%
Clover Health $3,857 105%
UnitedHealthcare $3,934 - $8,043 108%
Cigna $5,854 - $7,834 160%
Emblem Health $6,749 185%
Wellcare $7,675 210%
Qualcare Inc $9,057 248%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 110 Rehill Ave, Somerville, NJ 08876
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals