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Spigelian Hernia Repair

New York rates for HCPCS 49590

Surgery to fix a spigelian hernia, an uncommon hernia in which tissue pushes through a weak spot in the abdominal wall low down and off to the side, between the layers of muscle. Through an incision over the area the surgeon returns the bulging tissue to the abdomen and closes the defect, often reinforcing it with mesh.

Rates data updated July 2026.

How much does Spigelian Hernia Repair cost?

$5,370

Typical negotiated rate. In New York, July 2026.

Insurers have agreed to pay about $5,370 for this service. The price depends on where it is billed: about $813 from a physician practice, and about $5,495 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$813$617 to $832
FacilityA hospital or hospital-owned outpatient department$5,495$4,074 to $8,913

How much rates vary

Facilitymedian $5,495 · 10th to 90th $3,311 to $12,882Professionalmedian $813 · 10th to 90th $550 to $2,754
$1K$2K$5K$10Kfacility $5,495professional $813

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,548.13
Median
$5,495.41
Typical High
$12,882.50
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$812.83
Median
$1,995.26
Typical High
$8,912.51
CDPHP
Setting
Professional
Modifier
Global
Typical Low
$812.83
Median
$812.83
Typical High
$812.83
Cigna
Setting
Professional
Modifier
Global
Typical Low
$2,290.87
Median
$2,290.87
Typical High
$2,754.23
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$4,265.80
Median
$4,265.80
Typical High
$4,265.80
United
Setting
Facility
Modifier
Global
Typical Low
$1,230.27
Median
$3,235.94
Typical High
$5,248.07
United
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$616.60
Typical High
$831.76

Where New York 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.

New York· 6th of 49

$5,370

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.