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Repair of Upper Midline Hernia, Trapped

Washington 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 July 2026.

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

$977

Typical negotiated rate. In Washington, July 2026.

Insurers have agreed to pay about $977 for this service. The price depends on where it is billed: about $851 from a physician practice, and about $1,047 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 5 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$851$631 to $1,288
FacilityA hospital or hospital-owned outpatient department$1,047$692 to $1,995

How much rates vary

Facilitymedian $1,047 · 10th to 90th $513 to $3,236Professionalmedian $851 · 10th to 90th $457 to $2,291
$500$1K$2K$5K$10Kfacility $1,047professional $851

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
Cigna
Setting
Professional
Modifier
Global
Typical Low
$933.25
Median
$1,949.84
Typical High
$2,454.71
Kaiser Permanente
Setting
Facility
Modifier
Global
Typical Low
$512.86
Median
$1,071.52
Typical High
$3,235.94
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$457.09
Median
$851.14
Typical High
$2,290.87
Molina
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$70.79
Typical High
$79.43
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$630.96
Median
$851.14
Typical High
$1,000.00
United
Setting
Facility
Modifier
Global
Typical Low
$316.23
Median
$537.03
Typical High
$1,621.81
United
Setting
Professional
Modifier
Global
Typical Low
$426.58
Median
$724.44
Typical High
$1,000.00

Where Washington sits

The same service costs 407.4 times more in Indiana than in South Carolina. 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.

Washington· 38th of 49

$977

IN $12,303SC $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.