CMS Price Transparency Data

Inguinal hernia repair

Facility: UPMC Chautauqua at Wca

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $4,984
  • Cash Discount Price: $5,441
  • vs. Medicare Baseline: 1.36x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at UPMC Chautauqua at Wca is $4,984. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,441. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 1.36x the Medicare baseline. Located in 207 Foote Avenue, Jamestown, NY.
Cash / Self-Pay
$5,441

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,984

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: $5,441 (149%)
Insurance Median: $4,984 (136%)
Cash: $5,441 (149% of Medicare)
Ins. Median: $4,984 (136% 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
Upmc Health Plan $397 - $5,441 11%
Geisinger $441 12%
Health Partners Plans (Jefferson Health Plan) $479 13%
Magnacare $1,045 - $6,801 29%
Univera $1,198 - $1,902 33%
Blue Cross Blue Shield $1,581 - $3,040 43%
Beacon $4,312 - $5,390 118%
Fidelis $4,312 118%
Humana $4,312 - $7,254 118%
United Behavioral Health $4,312 118%
UnitedHealthcare $4,312 - $5,894 118%
Wellcare $4,441 121%
Aetna $4,484 - $5,894 123%
Independent Health $4,656 - $5,313 127%
Multiplan $6,801 186%
Ghi/Emblem Health $7,254 198%
Statewide Independent Ppo $7,980 218%
Affordable First Health $8,161 223%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 207 Foote Avenue, Jamestown, NY 14701
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals