CMS Price Transparency Data

Inguinal hernia repair

Facility: Sunrise Hospital and Medical Center

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $645
Cash Discount Price: $1,872
vs. Medicare Baseline: 0.18x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at Sunrise Hospital and Medical Center is $645. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,872. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.18x the Medicare baseline. Located in 3186 S Maryland Pkwy, Las Vegas, NV.

Cash / Self-Pay

$1,872

Average discount available for prompt cash payment at this facility.

Insurance Median

$645

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: $1,872 (51%)

Insurance Median: $645 (18%)

Cash: $1,872 (51% of Medicare)

Ins. Median: $645 (18% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Amerigroup	$322 - $596	9%
Health Plan Nevada	$322 - $626	9%
Humana	$334 - $4,370	9%
Molina	$338 - $657	9%
Silver Summit	$338 - $657	9%
Culinary Health Fund	$477 - $922	13%
Community Care Health	$491 - $1,155	13%
Molina Healthcare	$491 - $1,201	13%
Sierra Hpn	$491 - $1,155	13%
Healthcare Partners Of Nv	$495 - $671	14%
Aetna	$506 - $4,131	14%
Alignment Health Plan	$506	14%
Blue Cross Blue Shield	$506 - $4,589	14%
United	$516 - $3,180	14%
Caremore	$531	15%
Hometown Health Providers	$581 - $3,262	16%
Multiplan	$671 - $3,500	18%
Sierra	$675 - $3,106	18%
Cigna	$681 - $6,461	19%
Select Health	$1,024 - $5,307	28%
Caresource	$1,201	33%
Corvel	$2,147 - $2,572	59%
Olympus Medsave Usa	$2,260 - $2,707	62%
Legacy Provider Network	$2,436	67%
Ambetter / Centene	$2,626 - $3,335	72%
Comp-Med Workers Comp	$2,626	72%
Health Services Coalition	$4,260	116%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $1,872.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 49505.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Sunrise Hospital and Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 49505.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.