CMS Price Transparency Data

Inguinal hernia repair

Facility: Fairfield Medical Center

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $6,390
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.75x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Fairfield Medical Center is $6,390. 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 1.75x the Medicare baseline. Located in 401 North Ewing Street, Lancaster, OH.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$6,390

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: $6,390 (175%)
Ins. Median: $6,390 (175% 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
Medicaid / KanCare $2,258 62%
Molina $2,258 - $10,736 62%
UnitedHealthcare $2,258 - $6,507 62%
Caresource $2,281 - $8,458 62%
Blue Cross Blue Shield $2,326 - $26,250 64%
Humana $2,348 - $6,390 64%
Amerihealth Caritas Ohio $2,371 65%
Buckeye Community Health $2,371 - $10,085 65%
Aetna $6,390 175%
Medical Mutual $6,390 - $33,500 175%
Medicare (plans) $6,390 175%
Medigold $6,507 178%
Va Ccn $6,507 178%
The Health Plan $6,518 178%
Valor Health Plan $6,518 178%
Bwc $9,038 247%
Oscar $9,441 258%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 401 North Ewing Street, Lancaster, OH 43130
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals