CMS Price Transparency Data

Inguinal hernia repair

Facility: Carlsbad Medical Center

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $4,939
  • Cash Discount Price: $5,122
  • vs. Medicare Baseline: 1.35x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Carlsbad Medical Center is $4,939. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,122. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 1.35x the Medicare baseline. Located in 2430 West Pierce Street, Carlsbad, NM.
Cash / Self-Pay
$5,122

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,939

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: $5,122 (140%)
Insurance Median: $4,939 (135%)
Cash: $5,122 (140% of Medicare)
Ins. Median: $4,939 (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
Veterans Eval Services $509 14%
Blue Cross Blue Shield $2,613 - $46,243 71%
Medicaid / KanCare $2,613 - $3,224 71%
UnitedHealthcare $2,881 - $26,379 79%
Department Of Veterans Affairs $3,544 97%
Tricare $3,544 97%
Medicare (plans) $3,735 102%
Node Molina Mcr Adv $3,735 102%
Presbyterian $3,735 - $37,018 102%
Node Va $3,796 104%
Triwest $3,796 104%
Node Choice Care Mcr Adv $3,922 107%
Node Devoted Health Mcr Adv $3,922 107%
Us Department Of Labor $4,745 130%
Wexford Health $4,745 130%
Work Comp Nm $4,755 130%
Self Pay $5,122 140%
Node Molina Health Exchange $10,363 283%
Capstar $13,842 378%
Eddy County Detention $15,000 410%
Nm Health Connection $15,185 415%
Cigna $25,611 - $42,924 700%
Zelis $32,270 - $43,026 882%
Omni Network $33,294 910%
Choice Care $35,855 980%
Ccn First Health $40,977 1120%
Healthsmart $41,489 - $44,051 1134%
Aetna $43,026 1176%
Multiplan $43,026 1176%
Medical Control Inc $47,636 1302%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2430 West Pierce Street, Carlsbad, NM 88220
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals