CMS Price Transparency Data

Inguinal hernia repair

Facility: Mount Carmel Dublin

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 49505
Insurance Median: $10,352
Cash Discount Price: $55,510
vs. Medicare Baseline: 2.83x Medicare

The contracted insurance negotiated median rate for a Inguinal hernia repair at Mount Carmel Dublin is $10,352. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $55,510. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 2.83x the Medicare baseline. Located in 4105 Emerald Pkwy, Dublin, OH.

Cash / Self-Pay

$55,510

Average discount available for prompt cash payment at this facility.

Insurance Median

$10,352

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: $55,510 (1518%)

Insurance Median: $10,352 (283%)

Cash: $55,510 (1518% of Medicare)

Ins. Median: $10,352 (283% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 283% of the Medicare baseline (a markup of 183%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Aetna	$4,508 - $10,547	123%
UnitedHealthcare	$7,872 - $13,009	215%
Rural Carrier Health Benefit Plan	$8,144	223%
Medicare (plans)	$9,010 - $10,762	246%
American Postal Workers Secondary	$9,998	273%
Cigna	$9,998	273%
Health Partners	$9,998	273%
Healthgram	$9,998	273%
Mvp	$9,998	273%
Priority Health	$9,998	273%
Blue Cross Blue Shield	$10,045 - $31,803	275%
The Health Plan	$10,455	286%
Geha	$13,009	356%
Oscar	$16,912	462%
Enterprise Group Planning	$19,782	541%
Custom Design Benefits	$21,421	586%
Quality Care Partners	$23,164	633%
Medical Mutual	$25,187 - $34,722	689%
Western & Southern Financial Group	$34,722	949%

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 $55,510.
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 Mount Carmel Dublin 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.