CMS Price Transparency Data

Inguinal hernia repair

Facility: Physicians Regional Medical Center - Pine Ridge

Billing Code: 49505 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$5,486

about 1.5× the $3,658 Medicare rate · typically $3,927–$7,772

modeled estimate · not a bill or quote

What this hospital charges insurers

$4,483

Below the fair price — a good deal

about $1,003 under the fair price · 1.2× Medicare

Medicare pays $3,658 Fair price $5,486 This hospital $4,483 Cash price $15,096 Hospital's list price $71,885

How we calculate the fair BaseRate →

How this hospital compares to other FL hospitals

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

Cheapest $375 Priciest $4,483

Black dot = this hospital, among the 9 FL 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 $5,486 (about 1.5× the $3,658 Medicare rate). Physicians Regional Medical Center - Pine Ridge charges insurers about $4,483, or about $15,096 in cash — below the fair price — a good deal. Located in Naples, FL.

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	$2,501 - $17,396	68%
Blue Cross Blue Shieldmajor	$3,679 - $29,041	101%
Aetnamajor	$3,679 - $47,732	101%
Cignamajor	$13,005	356%
Humanamajor	$2,576 - $3,679	70%
Ambetter (Centene)	$9,534	261%
Amerigroup	$2,727	75%
AvMed	$27,316	747%
HealthPartners	$19,256	526%
Simply Healthcare	$2,652 - $3,000	72%
WellCare	$2,627 - $3,851	72%
+ 9 smaller / regional plans	$2,501 - $9,347

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

Excludes 3 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 15,096), 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 Physicians Regional Medical Center - Pine Ridge 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 Physicians Regional Medical Center - Pine Ridge

Compare: Inguinal hernia repair at other FL hospitals

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