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Open Inguinal Hernia Repair, First-Time

Washington 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 $8,913 · 10th–90th $759$19,9530%10%10th90th$8,913Professionalmedian $794 · 10th–90th $479$2,5120%10%20%10th90th$794$50.0$200.0$1.0K$5.0K$20.0K

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
$1,000.00
Median
$10,000.00
Typical High
$20,892.96
Aetna
Setting
Facility
Modifier
50 · Both sides
Typical Low
$11,220.18
Median
$18,197.01
Typical High
$43,651.58
Aetna
Setting
Professional
Modifier
Global
Typical Low
$478.63
Median
$794.33
Typical High
$2,630.27
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$457.09
Median
$812.83
Typical High
$1,047.13
Asuris Northwest Health
Setting
Facility
Modifier
Global
Typical Low
$7,244.36
Median
$9,120.11
Typical High
$18,620.87
Asuris Northwest Health
Setting
Facility
Modifier
50 · Both sides
Typical Low
$10,715.19
Median
$13,803.84
Typical High
$28,183.83
Asuris Northwest Health
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$1,000.00
Typical High
$1,318.26
Cigna
Setting
Facility
Modifier
Global
Typical Low
$891.25
Median
$1,071.52
Typical High
$4,786.30
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
$416.87
Median
$812.83
Typical High
$1,584.89
Kaiser Permanente
Setting
Facility
Modifier
Global
Typical Low
$549.54
Median
$1,047.13
Typical High
$4,168.69
Kaiser Permanente
Setting
Facility
Modifier
50 · Both sides
Typical Low
$9,549.93
Median
$10,715.19
Typical High
$16,595.87
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$912.01
Typical High
$2,187.76
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$302.00
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$676.08
Median
$1,000.00
Typical High
$1,023.29
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$724.44
Typical High
$2,691.53
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$1,023.29
Typical High
$1,513.56
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$7,079.46
Median
$9,549.93
Typical High
$18,620.87
Regence BlueShield
Setting
Facility
Modifier
50 · Both sides
Typical Low
$10,715.19
Median
$14,454.40
Typical High
$28,183.83
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$1,023.29
Typical High
$1,318.26
United
Setting
Facility
Modifier
Global
Typical Low
$2,137.96
Median
$10,232.93
Typical High
$19,952.62
United
Setting
Professional
Modifier
Global
Typical Low
$524.81
Median
$724.44
Typical High
$1,348.96
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$501.19
Median
$575.44
Typical High
$1,047.13