CMS Price Transparency Data

Inguinal hernia repair

Facility: Margaretville Memorial Hospital

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $5,119
  • Cash Discount Price: $11,436
  • vs. Medicare Baseline: 1.40x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Margaretville Memorial Hospital is $5,119. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $11,436. Compared to the federal Medicare reimbursement reference rate of $3,657.95, this hospital’s rate is 1.40x the Medicare baseline. Located in 42084 State Highway 28, Margaretville, NY.
Cash / Self-Pay
$11,436

Average discount available for prompt cash payment at this facility.

Insurance Median
$5,119

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: $11,436 (313%)
Insurance Median: $5,119 (140%)
Cash: $11,436 (313% of Medicare)
Ins. Median: $5,119 (140% 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
UnitedHealthcare $1,425 - $22,000 39%
Oxford Exchange $1,508 - $5,063 41%
Blue Cross Blue Shield $1,542 - $22,000 42%
Aetna $1,962 - $22,000 54%
Self-Pay $2,138 - $5,597 58%
Magnacare Preferred $2,267 - $6,453 62%
Mvp $3,477 95%
Mvp Exchange $3,616 - $7,433 99%
Mvp Hmo/Ppo $4,254 116%
Oxford $4,723 - $5,248 129%
Mvp Gold (McR) $5,032 - $22,000 138%
Medicare (plans) $5,032 - $23,540 138%
Hamaspik (McR) $5,032 - $22,000 138%
Affinity By Molina McR $5,283 - $23,100 144%
Cdphp $5,535 - $24,200 151%
Magnacare $6,088 166%
Emblem Ghi/Hip Ppo/Cbp $6,319 - $8,234 173%
Emblem $6,459 - $7,599 177%
Magnacare Standard $8,005 219%
Todays Options $8,303 227%
Emblem Ghi/Hip Hmo/Epo/Pos $9,149 250%
Multiplan $9,378 256%
First Health $10,292 281%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 42084 State Highway 28, Margaretville, NY 12455
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals