CMS Price Transparency Data

Inguinal hernia repair

Facility: Northwest Medical Center

Billing Code: 49505 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$4,260

about 1.2× the $3,658 Medicare rate · typically $1,885–$4,370

modeled estimate · not a bill or quote

What this hospital charges insurers

$4,362

About the fair price

about $102 over the fair price · 1.2× Medicare

Medicare pays $3,658 Fair price $4,260 This hospital $4,362 Cash price $16,012 Hospital's list price $66,715

How we calculate the fair BaseRate →

How this hospital compares to other AZ hospitals

Highest price of the 9 AZ hospitals we have prices for — worth calling around.

Cheapest $481 Priciest $4,362

Black dot = this hospital, among the 9 AZ hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Inguinal hernia repair is about $4,260 (about 1.2× the $3,658 Medicare rate). Northwest Medical Center charges insurers about $4,362, or about $16,012 in cash — about the fair price. Located in Tucson, AZ.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$3,759 - $33,357	103%
Blue Cross Blue Shieldmajor	$3,580 - $10,007	98%
Aetnamajor	$3,759 - $40,029	103%
Cignamajor	$3,759 - $5,073	103%
Humanamajor	$3,759	103%
Ambetter (Centene)	$5,387	147%
Banner Health	$3,947	108%
Clover Health	$3,859	105%
Devoted Health	$3,872	106%
Health Net	$6,056	166%
WellCare	$3,947	108%
+ 11 smaller / regional plans	$2,399 - $8,787

Government programs also on file: Medicare, Medicaid, Military & VA.

Excludes 4 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 16,012), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 49505.

Insurance Before you use insurance

Call your insurance company to confirm Northwest Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 49505.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Northwest Medical Center

Compare: Inguinal hernia repair at other AZ hospitals

Insurance negotiated median for the same procedure, sorted lowest first.