CMS Price Transparency Data

Inguinal hernia repair

Facility: Ohio Valley Surgical Hospital

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $3,363
  • Cash Discount Price: $10,111
  • vs. Medicare Baseline: 0.92x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Ohio Valley Surgical Hospital is $3,363. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $10,111. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.92x the Medicare baseline. Located in 100 West Main Street, Springfield, OH.
Cash / Self-Pay
$10,111

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,363

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: $10,111 (276%)
Insurance Median: $3,363 (92%)
Cash: $10,111 (276% of Medicare)
Ins. Median: $3,363 (92% 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
Aetna $631 - $3,363 17%
Geha $631 17%
Genworth $631 17%
Mail Handlers $631 17%
Meritain $631 17%
Meritain Heatlh $631 17%
Mhbp $631 17%
Ngs Coresource $631 17%
Nippon Life $631 17%
Pacific Source $631 17%
Personify Health $631 17%
Aarp $3,363 92%
Aarp Supplemental $3,363 92%
American Continental Insurance $3,363 92%
American Continental Life $3,363 92%
American Republic $3,363 92%
American Retirement $3,363 92%
Aultcare Primetime Health Plan $3,363 92%
Bankers Fidelity $3,363 92%
Bankers Life And Casualty $3,363 92%
Blue Cross Blue Shield $3,363 - $16,599 92%
Central States $3,363 92%
Champus $3,363 92%
Cigna $3,363 - $5,169 92%
Communicare Advantage $3,363 92%
Everest $3,363 92%
Gateway Health Plan $3,363 92%
Humana $3,363 92%
Medicare (plans) $3,363 - $10,111 92%
Medigold $3,363 92%
Mmoh $3,363 - $10,617 92%
Molina $3,363 92%
Molina Dual Mcr $3,363 92%
Molina Marketplace $3,363 92%
Molina Dual Mcr $3,363 92%
Molina Mcr $3,363 92%
Molina Mcr Mcd $3,363 92%
Molina Mcr+Mcd $3,363 92%
Patient No Pay $3,363 92%
Prosperity Supplement $3,363 92%
Self Pay Imaging $3,363 92%
UnitedHealthcare $3,363 - $4,494 92%
Wellcare By Allwell $3,363 92%
Wraparound Pl Supp $3,363 92%
The Health Plan $3,532 97%
Employer Direct $3,868 106%
Devoted Health $3,986 109%
Caresource $5,045 138%
Caresourse $5,045 138%
Medicaid / KanCare $5,045 138%
Healthgram $5,169 141%
Nalc $5,169 141%
Samba $5,169 141%
Sbma $5,169 141%
Unified Group $5,169 141%
Mmoh (Supermed) $7,836 214%
Mmo Cin. Hmo $10,617 290%
Luminare Health $15,167 415%
Medben $15,167 415%
Ohio Health $15,167 415%
Preferred Health $15,167 415%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 West Main Street, Springfield, OH 45502
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals