CMS Price Transparency Data

Inguinal hernia repair

Facility: Mt Sinai Hospital Medical Center

Billing Code: 49505 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$3,940

about 1.1× the $3,658 Medicare rate · typically $3,657–$4,546

modeled estimate · not a bill or quote

Medicare pays $3,658 Fair price $3,940 Cash price $1,292 Hospital's list price $1,846

How we calculate the fair BaseRate →

What each insurance company pays

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

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

✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana UnitedHealthcareKaiser 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
Blue Cross Blue Shieldmajor	$825 - $5,298	23%
Aetnamajor	$4,173 - $5,298	114%
Cignamajor	$2,282 - $5,563	62%
Humanamajor	$3,837 - $5,798	105%
Ambetter (Centene)	$1,939 - $4,220	53%
Health Net	$3,722 - $5,298	102%
HealthLink	$1,200	33%
Meridian	$3,837	105%
Molina	$4,029 - $5,563	110%
Oscar Health	$2,031	56%
+ 10 smaller / regional plans	$739 - $4,220

Government programs also on file: Military & VA.

Excludes 6 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 1,292), 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 Mt Sinai Hospital 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 Mt Sinai Hospital Medical Center

Compare: Inguinal hernia repair at other IL hospitals

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