CMS Price Transparency Data

Inguinal hernia repair

Facility: Mercy Hospital Ardmore, Inc

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $3,527
  • Cash Discount Price: $9,209
  • vs. Medicare Baseline: 0.96x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Mercy Hospital Ardmore, Inc is $3,527. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $9,209. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.96x the Medicare baseline. Located in 1011 14Th Ave Nw, Ardmore, OK.
Cash / Self-Pay
$9,209

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,527

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: $9,209 (252%)
Insurance Median: $3,527 (96%)
Cash: $9,209 (252% of Medicare)
Ins. Median: $3,527 (96% 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 $488 - $3,529 13%
Aetna $3,143 - $3,527 86%
Humana $3,143 - $3,595 86%
Medicaid / KanCare $3,143 - $4,854 86%
Cherokee Nation Health Serv Contracted [320066] $3,527 96%
Cross Timbers Hospice [20098] $3,527 96%
Dept Of Veteran Affairs Contracted [320106] $3,527 96%
Elara Caring Aspire Hospice Contracted [320433] $3,527 96%
Elara Caring Aspire Hospice [20433] $3,527 96%
Halo Hcr Inc Hospice Contracted [320432] $3,527 96%
Halo Hcr Inc Hospice [20432] $3,527 96%
Independent Health [20197] $3,527 96%
Indian Health Service Contracted [320198] $3,527 96%
Kindful Hospice Contracted [320434] $3,527 96%
Kindful Hospice [20434] $3,527 96%
Medical Associates Health [20444] $3,527 96%
Medicare (plans) $3,527 - $3,739 96%
Mercy Hospice Okc [20252] $3,527 96%
Provider Partners Health Plans Contracted [320450] $3,527 96%
Qual Choice Contracted [320325] $3,527 96%
Tribute Health Plan Mcr Contracted [320338] $3,527 96%
Tricare $3,527 96%
UnitedHealthcare $3,595 98%
Globalhealth Contracted [320145] $3,599 98%
Cigna $3,635 - $4,409 99%
Ambetter / Centene $4,854 133%
Home State Health Plan Contracted [320187] $4,854 133%
Novasys Contracted [320285] $4,854 133%
Workers Comp [20426] $5,161 141%
Community Care Contracted [320080] $5,393 147%
Health Choice Contracted [320166] $7,058 193%
Healthsmart Preferred Care Contracted [320184] $7,936 217%
Kempton Contracted [320214] $7,936 217%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1011 14Th Ave Nw, Ardmore, OK 73401
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals