CMS Price Transparency Data

Inguinal hernia repair

Facility: Garnet Health Medical Center

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $4,148
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.13x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Garnet Health Medical Center is $4,148. 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 1.13x the Medicare baseline. Located in 707 East Main Street, Middletown, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,148

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: $4,148 (113%)
Ins. Median: $4,148 (113% 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
Magnacare $1,517 - $2,427 41%
Aetna $2,245 - $4,469 61%
Local 1199 $2,245 - $3,827 61%
Mvp $2,653 73%
Emblem Health $2,756 75%
UnitedHealthcare $3,262 89%
Fidelis $4,559 125%
Wellcare $4,572 125%
Blue Cross Blue Shield $5,377 - $5,501 147%
Cigna $5,386 147%
Cdphp $6,647 182%
Rojw $7,821 214%
Northwell Direct $9,162 250%
Geisinger Health Plan $11,173 305%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 707 East Main Street, Middletown, NY 10940
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals