CMS Price Transparency Data

Inguinal hernia repair

Facility: Montefiore Mount Vernon Hospital

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $4,872
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.33x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Montefiore Mount Vernon Hospital is $4,872. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 1.33x the Medicare baseline. Located in 12 North 7Th Avenue, Mount Vernon, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,872

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%)
Insurance Median: $4,872 (133%)
Ins. Median: $4,872 (133% 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
American Postal Workers $540 - $17,650 15%
UnitedHealthcare $540 - $17,650 15%
Metroplus $617 - $5,810 17%
Healthfirst $1,106 - $4,469 30%
Oscar $3,549 - $7,276 97%
Blue Cross Blue Shield $4,317 - $10,052 118%
Fidelis $4,469 122%
Point Comfort $4,469 122%
Villagecaremax $4,469 122%
Vnsny Choice $4,469 122%
Wellcare $4,559 125%
Centerlight $4,603 - $4,916 126%
Elderplan $4,603 126%
Partners Health Plan $4,693 128%
Longevity $4,872 133%
Humana $4,916 134%
Aetna $5,250 - $5,873 144%
Emblem $5,363 - $18,107 147%
Molina Healthcare Of Ny Affinity $6,168 169%
Mvp $6,666 182%
Northwell $12,023 329%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12 North 7Th Avenue, Mount Vernon, NY 10550
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals