CMS Price Transparency Data

Inguinal hernia repair

Facility: Caribbean Medical Center

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $692
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.19x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Caribbean Medical Center is $692. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.19x the Medicare baseline. Located in 151 Ave Osvaldo Molina, Fajardo, PR.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$692

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%)
Insurance Median: $692 (19%)
Ins. Median: $692 (19% 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
Humana $489 13%
Medicare (plans) $489 13%
Mmm $489 13%
Tricare $489 13%
Well Care $489 13%
Acaa $500 14%
Cfse $504 14%
Triples S Reforma $504 - $689 14%
Imc Privado $608 17%
Mcs Classicare $623 17%
Mcs Privado $623 17%
Panamerican Life Insurance $625 17%
Asociacion De Maestros Pr $648 18%
Menonita Ases $656 - $689 18%
First Medical Ases $695 19%
Hoffa $695 19%
Union Carpinteros $700 19%
Auxilio Mutuo $741 - $760 20%
Auxilio Mutuo Plus $741 - $760 20%
Triple S Privado $741 - $783 20%
Menonita Privado $750 21%
Mapfre $754 21%
Mmm Multi Health Ases $791 22%
Tsa $951 26%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 151 Ave Osvaldo Molina, Fajardo, PR 00738
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals