CMS Price Transparency Data

Inguinal hernia repair

Facility: Northside Hospital

Billing Code: 49505 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$2,718

about 0.7× the $3,658 Medicare rate · typically $1,102–$4,185

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,309

Below the fair price — a good deal

about $1,409 under the fair price · 0.4× Medicare

Medicare pays $3,658 Fair price $2,718 This hospital $1,309 Cash price $1,200 Hospital's list price $1,600

How we calculate the fair BaseRate →

How this hospital compares to other GA hospitals

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

Cheapest $375 Priciest $1,309

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

A fair price for a Inguinal hernia repair is about $2,718 (about 0.7× the $3,658 Medicare rate). Northside Hospital charges insurers about $1,309, or about $1,200 in cash — below the fair price — a good deal. Located in Atlanta, GA.

What each insurance company pays

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

6 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	$525 - $8,836	14%
Blue Cross Blue Shieldmajor	$525 - $34,850	14%
Aetnamajor	$525 - $30,000	14%
Cignamajor	$541 - $8,162	15%
Humanamajor	$525 - $3,722	14%
Kaiser Permanentemajor	$525 - $6,053	14%
Ambetter (Centene)	$364 - $10,234	10%
Amerigroup	$364 - $9,085	10%
CareSource	$364 - $18,600	10%
Clover Health	$551 - $3,757	15%
Health Net	$878 - $8,102	24%
Oscar Health	$709 - $7,706	19%
WellCare	$525 - $3,686	14%
+ 16 smaller / regional plans	$551 - $50,000

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

Excludes 7 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 1,200), 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 Northside Hospital 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 Northside Hospital

Compare: Inguinal hernia repair at other GA hospitals

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