CMS Price Transparency Data

Inguinal hernia repair

Facility: Mon Health Medical Center

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $516
  • Cash Discount Price: $566
  • vs. Medicare Baseline: 0.14x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Mon Health Medical Center is $516. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $566. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 0.14x the Medicare baseline. Located in 1200 Jd Anderson Drive, Morgantown, WV.
Cash / Self-Pay
$566

Average discount available for prompt cash payment at this facility.

Insurance Median
$516

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: $566 (15%)
Insurance Median: $516 (14%)
Cash: $566 (15% of Medicare)
Ins. Median: $516 (14% 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
Gateway_Health_Plan $318 9%
Unison_Plan $318 9%
Maryland_Physicians_Care_Plan $420 11%
Geha_Plan $453 12%
Aetna $514 14%
Blue Cross Blue Shield $514 - $899 14%
Medicare (plans) $514 14%
Paramount_Elite_Plan $514 14%
Uhc_Onenet_Ppo_Plan $514 14%
Uhc_Options_Ppo_Plan $514 14%
Uhc_Plan $514 14%
Umwa_Plan $514 14%
Health_South_Mountain_View_Plan $517 14%
Upmc__Plan $539 15%
The_Health_Plan_Peia_Plan $676 18%
Humana $805 22%
The_Health_Plan_Murray_Energy_Commercial_Aso_Plan $950 26%
Acpn_Plan $1,020 28%
Seven_Corners_Plan $1,028 28%
Zelis_Group_Health_Plan $1,049 29%
Zelis_Other_Plan $1,049 29%
Cigna $1,218 33%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1200 Jd Anderson Drive, Morgantown, WV 26505
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals