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Open Inguinal Hernia Repair, First-Time

Pennsylvania rates for HCPCS 49505

A surgeon repairs a groin hernia, where tissue has pushed through a weak spot in the abdominal wall, using an open surgical incision rather than small laparoscopic ports. This version is for a hernia that has not been repaired before and can still be pushed back into place before surgery. Mesh may be used to reinforce the area, depending on the case.

Facilitymedian $6,761 · 10th–90th $1,660$14,1250%10%10th90th$6,761Professionalmedian $776 · 10th–90th $479$1,8620%20%10th90th$776$5.0$20.0$100.0$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$1,659.59
Median
$6,760.83
Typical High
$12,589.25
Aetna
Setting
Facility
Modifier
50 · Both sides
Typical Low
$4,677.35
Median
$7,585.78
Typical High
$17,378.01
Aetna
Setting
Professional
Modifier
Global
Typical Low
$478.63
Median
$794.33
Typical High
$1,949.84
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$501.19
Typical High
$812.83
AmeriHealth
Setting
Facility
Modifier
Global
Typical Low
$4,365.16
Median
$6,025.60
Typical High
$52,480.75
AmeriHealth
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$549.54
Typical High
$707.95
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$7,585.78
Median
$8,709.64
Typical High
$57,543.99
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$524.81
Median
$549.54
Typical High
$954.99
Cigna
Setting
Facility
Modifier
Global
Typical Low
$645.65
Median
$2,089.30
Typical High
$4,466.84
Cigna
Setting
Facility
Modifier
22 · Increased work
Typical Low
$1,071.52
Median
$1,071.52
Typical High
$1,071.52
Cigna
Setting
Facility
Modifier
AS · PA/NP assist
Typical Low
$89.13
Median
$89.13
Typical High
$89.13
Cigna
Setting
Professional
Modifier
Global
Typical Low
$380.19
Median
$602.56
Typical High
$1,071.52
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$1,148.15
Median
$1,148.15
Typical High
$1,148.15
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$758.58
Typical High
$1,047.13
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$1,905.46
Median
$2,630.27
Typical High
$3,019.95
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$467.74
Median
$562.34
Typical High
$891.25
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,311.31
Median
$8,511.38
Typical High
$13,803.84
Highmark BCBS
Setting
Facility
Modifier
22 · Increased work
Typical Low
$6,760.83
Median
$6,760.83
Typical High
$6,760.83
Highmark BCBS
Setting
Facility
Modifier
50 · Both sides
Typical Low
$3,311.31
Median
$13,489.63
Typical High
$25,118.86
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$575.44
Typical High
$758.58
Independence Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$3,630.78
Median
$5,495.41
Typical High
$25,703.96
Independence Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$549.54
Typical High
$707.95
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$575.44
Median
$4,265.80
Typical High
$9,772.37
Martin's Point
Setting
Facility
Modifier
50 · Both sides
Typical Low
$25,703.96
Median
$25,703.96
Typical High
$25,703.96
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$676.08
Typical High
$1,202.26
Oscar Health
Setting
Facility
Modifier
Global
Typical Low
$524.81
Median
$5,623.41
Typical High
$7,079.46
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$524.81
Median
$933.25
Typical High
$1,148.15
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$446.68
Median
$537.03
Typical High
$575.44
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$537.03
Typical High
$575.44
United
Setting
Facility
Modifier
Global
Typical Low
$1,380.38
Median
$4,073.80
Typical High
$11,481.54
United
Setting
Professional
Modifier
Global
Typical Low
$436.52
Median
$575.44
Typical High
$1,000.00