CMS Price Transparency Data

Inguinal hernia repair

Facility: Cleveland Clinic Avon Hospital

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $5,579
  • Cash Discount Price: $9,257
  • vs. Medicare Baseline: 1.53x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Cleveland Clinic Avon Hospital is $5,579. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $9,257. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 1.53x the Medicare baseline. Located in 33300 Cleveland Clinic Blvd, Avon, OH.
Cash / Self-Pay
$9,257

Average discount available for prompt cash payment at this facility.

Insurance Median
$5,579

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: $9,257 (253%)
Insurance Median: $5,579 (153%)
Cash: $9,257 (253% of Medicare)
Ins. Median: $5,579 (153% 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
Blue Cross Blue Shield $2,057 - $11,158 56%
Buckeye $2,057 56%
Molina $2,057 56%
Caresource $2,096 57%
United $2,096 - $6,757 57%
Aetna $3,272 - $14,241 89%
Devoted Health $3,272 89%
Humana $3,272 89%
Mmo $3,272 - $3,656 89%
Summacare $3,272 - $5,725 89%
The Health Plan $3,272 - $8,545 89%
UnitedHealthcare $3,272 - $8,829 89%
Upmc $3,272 - $8,545 89%
Valor $3,272 89%
Cigna $3,370 - $7,420 92%
Communicare $3,435 94%
Perennial Health $3,533 97%
Pphp $3,599 98%
Zing Health $3,599 98%
Oscar $4,291 - $5,476 117%
Cc Ehp $5,682 - $5,768 155%
Aultcare $6,124 167%
Amish Community Aid Plan $6,408 - $7,120 175%
Ohcp $6,921 189%
Omas $7,120 195%
Ohio Healthy $7,690 210%
Php $8,545 234%
Gms $9,969 273%
Medical Benefit Corp $9,969 273%
Consociate Health $10,681 292%
Frontpath $12,817 350%
Managed Care Services $12,817 350%
Multiplan $12,817 350%
Tertiary Care Network $12,817 350%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 33300 Cleveland Clinic Blvd, Avon, OH 44011
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals