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Initial Inguinal Hernia Repair In A Young Child

New Jersey rates for HCPCS 49500

This is a surgical repair of a first-time groin hernia in a young child, performed through an open incision to close the weak spot in the abdominal wall where tissue has been bulging through. It is used when the hernia can be gently pushed back into place, rather than being trapped or cutting off blood flow to the bulging tissue. It applies to a child within a specific young age range, distinct from the repair approach used in infants or in older children and adults.

Rates data updated July 2026.

How much does Initial Inguinal Hernia Repair In A Young Child cost?

$490

Typical negotiated rate. In New Jersey, July 2026.

Insurers have agreed to pay about $490 for this service. The price depends on where it is billed: about $447 from a physician practice, and about $7,079 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$447$389 to $617
FacilityA hospital or hospital-owned outpatient department$7,079$5,495 to $10,233

How much rates vary

Facilitymedian $7,079 · 10th to 90th $3,311 to $11,749Professionalmedian $447 · 10th to 90th $339 to $1,023
$500$1K$2K$5K$10K$20Kfacility $7,079professional $447

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$4,365.16
Median
$7,079.46
Typical High
$11,481.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$426.58
Typical High
$3,162.28
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$371.54
Median
$371.54
Typical High
$371.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$501.19
Typical High
$977.24
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$602.56
Typical High
$870.96
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$13,182.57
Median
$19,952.62
Typical High
$31,622.78
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$467.74
Typical High
$912.01
United
Setting
Facility
Modifier
Global
Typical Low
$2,951.21
Median
$7,079.46
Typical High
$14,454.40
United
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$457.09
Typical High
$891.25

Where New Jersey sits

The same service costs 2.5 times more in Minnesota than in Vermont. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

New Jersey· 32nd of 51

$490

MN $977VT $398

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.