CMS Price Transparency Data

Inguinal hernia repair

Facility: Fisher-Titus Hospital

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $942
Cash Discount Price: $1,211
vs. Medicare Baseline: 0.26x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at Fisher-Titus Hospital is $942. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,211. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.26x the Medicare baseline. Located in 272 Benedict Avenue, Norwalk, OH.

Cash / Self-Pay

$1,211

Average discount available for prompt cash payment at this facility.

Insurance Median

$942

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: $1,211 (33%)

Insurance Median: $942 (26%)

Cash: $1,211 (33% of Medicare)

Ins. Median: $942 (26% 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
Perennial Advantage	$80 - $3,476	2%
UnitedHealthcare	$80 - $3,377	2%
Sidecar	$82 - $7,398	2%
Humana	$314 - $500	9%
Aetna	$404 - $3,310	11%
Martin'S Point	$425 - $500	12%
Blue Cross Blue Shield	$500 - $3,310	14%
Buckeye	$500 - $3,310	14%
Caresource	$500 - $3,310	14%
Devoted	$500	14%
Medical Mutual Of Ohio	$500 - $3,310	14%
Medigold	$500	14%
Meridan	$500	14%
Paramount	$500 - $3,310	14%
Summacare	$500 - $3,310	14%
Zinghealth	$510	14%
Valor Health	$516 - $3,410	14%
Gateway	$526	14%
Perennial	$526	14%
Wellcare	$526 - $3,310	14%
Health Scope	$601	16%
Emerald Health	$626 - $1,305	17%
Frontpath	$651	18%
Ohio Health Choice	$651 - $1,210	18%
Cigna	$701 - $1,076	19%
Clarity Health	$701	19%
Multiplan	$701 - $1,210	19%
Coresource	$704	19%
First Health	$704 - $1,210	19%
Health Ohio Network	$751 - $942	21%
Tricare	$1,009 - $1,076	28%
Claimsdoc	$1,076	29%
Healthscope	$1,224	33%
Amerihealth	$1,546	42%
Molina	$1,546	42%
Zing Health	$3,310	90%

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 $1,211.
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 Fisher-Titus Hospital 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.