CMS Price Transparency Data

Inguinal hernia repair

Facility: Metropolitan Hospital Center

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $3,403
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.93x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Metropolitan Hospital Center is $3,403. 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 0.93x the Medicare baseline. Located in 1901 First Avenue, New York, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,403

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: $3,403 (93%)
Ins. Median: $3,403 (93% 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
Healthfirst $504 - $5,587 14%
Aetna $617 - $3,076 17%
Wellcare $680 19%
Fidelis $907 - $5,930 25%
Metroplus $1,200 - $5,587 33%
Amidacare $2,483 68%
Blue Cross Blue Shield $2,483 - $5,587 68%
Carelon $2,483 - $7,106 68%
Senior Whole Health $2,483 68%
United $2,483 - $4,660 68%
United Behavioral Health $2,483 - $2,731 68%
Affinity $2,533 - $5,587 69%
Carelon (Amida Care) $2,533 69%
Vnsny $2,533 - $4,176 69%
Local 1199 $3,284 90%
Oxford $3,326 - $3,773 91%
Emblem $3,724 - $5,220 102%
Elderplan $4,176 114%
Vaccn $4,176 114%
Cigna $4,285 117%
Centers Plan For Healthy Living $4,343 119%
Oscar $4,454 122%
Centerlight $5,466 149%
Magnacare $8,199 224%
Multiplan $8,746 239%
Villagecare Max $9,292 254%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1901 First Avenue, New York, NY 10029
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals