CMS Price Transparency Data

Inguinal hernia repair

Facility: Ohiohealth Morrow County Hospital

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $1,497
  • Cash Discount Price: $1,179
  • vs. Medicare Baseline: 0.41x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Ohiohealth Morrow County Hospital is $1,497. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,179. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.41x the Medicare baseline. Located in 651 West Marion Road, Mount Gilead, OH.
Cash / Self-Pay
$1,179

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,497

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: $1,179 (32%)
Insurance Median: $1,497 (41%)
Cash: $1,179 (32% of Medicare)
Ins. Median: $1,497 (41% 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 $671 - $3,024 18%
Medicare (plans) $671 - $685 18%
UnitedHealthcare $671 - $2,994 18%
Humana $678 - $3,084 19%
Aetna $684 - $1,560 19%
Caresource Marketplace - All Other Plans $839 23%
Medical Mutual Of Ohio Marketplace $1,361 37%
Ohiohealthy Network - All Other Plans $1,361 37%
Ohiohealthy Preferred $1,361 37%
Medical Mutual Of Ohio Comm - All Other Plans $1,470 40%
Medicaid / KanCare $1,497 - $3,054 41%
Medical Mutual Of Ohio - Admin Serv $1,542 42%
Phcs - All Plans $1,669 46%
Cigna $1,705 47%
Multiplan - All Plans $1,723 47%
Healthstar Comm - All Plans $1,742 48%
Beech Street - All Plans $1,760 48%
Amerihealth Caritas - All Plans $3,084 84%
Molina Exchange - All Other Plans $4,940 135%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 651 West Marion Road, Mount Gilead, OH 43338
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals