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Repair of Upper Midline Hernia, Trapped

Pennsylvania rates for HCPCS 49572

Surgery to repair an epigastric hernia, a bulge through a weak spot in the midline of the abdominal wall between the navel and the breastbone, in the situation where the bulging tissue is stuck and cannot be pushed back or its blood supply is being pinched off. The surgeon opens over the site, frees and inspects the trapped tissue, and closes the gap in the wall.

Rates data updated October 2026.

How much does Repair of Upper Midline Hernia, Trapped cost?

$468

Typical physician fee. In Pennsylvania, October 2026.

Insurers have agreed to pay about $468 for this service. Most negotiated rates run $447 to $525.

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 4 insurance carriers under federal price transparency rules.

How much rates vary

Professionalmedian $468 · 10th to 90th $427 to $955
$500$1Kprofessional $468

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Cigna
Setting
Professional
Modifier
None
Typical Low
$1,412.54
Median
$1,412.54
Typical High
$1,584.89
Geisinger
Setting
Professional
Modifier
None
Typical Low
$426.58
Median
$446.68
Typical High
$691.83
Oscar Health
Setting
Professional
Modifier
None
Typical Low
$467.74
Median
$489.78
Typical High
$954.99
United
Setting
Professional
Modifier
None
Typical Low
$389.05
Median
$501.19
Typical High
$676.08

Where Pennsylvania sits

The same service costs 389.0 times more in Connecticut than in Idaho. 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.

Pennsylvania· 38th of 43

$468

CT $11,749ID $30.20

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.