CMS Price Transparency Data

Inguinal hernia repair

Facility: Atrium Health Navicent Rehabilitation Hopsital

Billing Code: 49505 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$1,291

about 0.4× the $3,658 Medicare rate · typically $566–$2,531

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,198

About the fair price

about $93 under the fair price · 0.3× Medicare

Medicare pays $3,658 Fair price $1,291 This hospital $1,198

How we calculate the fair BaseRate →

How this hospital compares to other GA hospitals

On the higher side — 7 of 8 other GA hospitals charge less.

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 $1,291 (about 0.4× the $3,658 Medicare rate). Atrium Health Navicent Rehabilitation Hopsital charges insurers about $1,198 — about the fair price. Located in Macon, 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	$501 - $3,529	14%
Blue Cross Blue Shieldmajor	$501 - $3,529	14%
Aetnamajor	$501 - $3,529	14%
Cignamajor	$838 - $3,830	23%
Humanamajor	$501 - $4,453	14%
Kaiser Permanentemajor	$1,122 - $3,256	31%
Ambetter (Centene)	$676	18%
Clover Health	$511 - $3,600	14%
+ 7 smaller / regional plans	$501 - $3,600

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, 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 Atrium Health Navicent Rehabilitation Hopsital 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 Atrium Health Navicent Rehabilitation Hopsital

Compare: Inguinal hernia repair at other GA hospitals

Bacon County Hospital · Alma $375
Atrium Health Navicent Peach · Byron $603
Shepherd Center, Inc. · Atlanta $635
Grady Memorial Hospital · Atlanta $785
Navicent Health Baldwin · Milledgeville $1,022
Northside Hospital Duluth · Duluth $1,104
Atrium Health Navicent the Medical Center · Macon $1,160
Northside Hospital Forsyth · Cumming $1,309

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