CMS Price Transparency Data

Inguinal hernia repair

Facility: Cincinnati Children's Hospital Medical Center

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $2,346
  • Cash Discount Price: $1,952
  • vs. Medicare Baseline: 0.64x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Cincinnati Children's Hospital Medical Center is $2,346. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,952. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.64x the Medicare baseline. Located in 3333 Burnet Avenue, Cincinnati, OH.
Cash / Self-Pay
$1,952

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,346

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: $1,952 (53%)
Insurance Median: $2,346 (64%)
Cash: $1,952 (53% of Medicare)
Ins. Median: $2,346 (64% 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 $263 - $3,828 7%
Humana $276 - $368 8%
Wellcare_Ky $276 - $368 8%
United_Health_Care_Ky $277 - $369 8%
Blue Cross Blue Shield $280 - $2,760 8%
Caresource_Oh $280 - $329 8%
Amerihealth_Caritas_Oh $288 - $339 8%
Molina_Oh $293 - $345 8%
Buckeye_Oh $307 - $361 8%
United_Health_Care_Oh $333 - $392 9%
Passport_Ky $364 10%
Caresource_In $368 - $491 10%
United_Health_Care_Insurance $1,361 - $3,042 37%
Caresource_Oh_Insurance $1,914 52%
Medical_Mutual_Of_Ohio_Insurance $2,050 - $3,483 56%
Parkview_Signature_Care_Insurance $2,346 - $2,760 64%
Point_Comfort_Insurance $2,488 68%
Margaret_Mary_Health_Insurance $2,538 - $2,986 69%
Cigna $2,603 - $3,062 71%
Health_Ohio_Network_Insurance $3,062 - $3,637 84%
Beechstreet_Insurance $3,091 - $3,637 85%
Evolutions_Health_Care_Systems $3,445 94%
Galaxy_Health_Insurance $3,445 94%
Custom_Design_Benefits_Insurance $3,637 99%
First_Health_Group_Insurance $3,637 99%
Health_Link_Insurance $3,637 99%
Health_Smart_Preferred_Insurance $3,637 99%
Medical_Benefit_Administrators_Insurance $3,637 99%
Ohio_Health_Choice_Insurance $3,637 99%
Private_Health_Care_Systems_Insurance $3,828 105%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3333 Burnet Avenue, Cincinnati, OH 45229
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens