CMS Price Transparency Data

Inguinal hernia repair

Facility: Clearwater Valley Hospital & Clinics

Billing Code: 49505 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$806

about 0.2× the $3,658 Medicare rate · typically $493–$2,128

modeled estimate · not a bill or quote

What this hospital charges insurers

$526

Below the fair price — a good deal

about $280 under the fair price · 0.1× Medicare

Medicare pays $3,658 Fair price $806 This hospital $526 Cash price $919 Hospital's list price $1,225

How we calculate the fair BaseRate →

How this hospital compares to other ID hospitals

One of the lower prices — 6 of 8 other ID hospitals charge more for the same procedure.

Cheapest $464 Priciest $2,048

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

A fair price for a Inguinal hernia repair is about $806 (about 0.2× the $3,658 Medicare rate). Clearwater Valley Hospital & Clinics charges insurers about $526, or about $919 in cash — below the fair price — a good deal. Located in Orofino, ID.

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	$879	24%
Blue Cross Blue Shieldmajor	$400 - $800	11%
Aetnamajor	$732	20%
Cignamajor	$954	26%
Humanamajor	$458 - $723	13%
GEHA	$1,188	32%
+ 5 smaller / regional plans	$458 - $1,200

Government programs also on file: Military & VA.

Excludes 1 rental-network / third-party entry (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 919), 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 Clearwater Valley Hospital & Clinics 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 Clearwater Valley Hospital & Clinics

Compare: Inguinal hernia repair at other ID hospitals

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