CMS Price Transparency Data

Inguinal hernia repair

Facility: Memorial Hospital for Cancer and Allied Diseases

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $2,629
Cash Discount Price: $4,581
vs. Medicare Baseline: 0.72x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at Memorial Hospital for Cancer and Allied Diseases is $2,629. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,581. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.72x the Medicare baseline. Located in 1275 York Ave, New York, NY.

Cash / Self-Pay

$4,581

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,629

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: $4,581 (125%)

Insurance Median: $2,629 (72%)

Cash: $4,581 (125% of Medicare)

Ins. Median: $2,629 (72% 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
Emblem	$234 - $2,601	6%
Aetna	$607 - $9,298	17%
Fidelis	$607	17%
Healthfirst	$607 - $1,760	17%
Metroplus	$607	17%
Empire	$2,398 - $8,769	66%
Magnacare	$2,639 - $4,398	72%
Urn	$2,859 - $4,288	78%
Oxford	$2,883 - $11,124	79%
6 Degrees Health	$2,932 - $4,398	80%
Multiplan	$3,298 - $4,948	90%
Cigna	$3,354 - $7,763	92%
UnitedHealthcare	$3,562 - $12,625	97%

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 $4,581.
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 Memorial Hospital for Cancer and Allied Diseases 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.