CMS Price Transparency Data

Inguinal hernia repair

Facility: St Claire Regional Medical Center

Billing Code: 49505 (CPT)

The BaseRate · fair price low confidence

A fair price for this

$2,055

about 0.6× the $3,658 Medicare rate · typically $483–$5,522

modeled estimate · not a bill or quote

What this hospital charges insurers

$511

Below the fair price — a good deal

about $1,544 under the fair price · 0.1× Medicare

Medicare pays $3,658 Fair price $2,055 This hospital $511 Cash price $543 Hospital's list price $724

How we calculate the fair BaseRate →

How this hospital compares to other KY hospitals

On the higher side — 6 of 8 other KY hospitals charge less.

Cheapest $476 Priciest $586

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

A fair price for a Inguinal hernia repair is about $2,055 (about 0.6× the $3,658 Medicare rate). St Claire Regional Medical Center charges insurers about $511, or about $543 in cash — below the fair price — a good deal. Located in Morehead, KY.

What each insurance company pays

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

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

✓ Blue Cross Blue Shield✓ Aetna✓ Humana UnitedHealthcareCignaKaiser 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	$482 - $511	13%
Aetnamajor	$724	20%
Humanamajor	$482 - $603	13%
CareSource	$482 - $675	13%
HealthLink	$511	14%
WellCare	$603 - $738	16%
+ 1 smaller / regional plan	$627

Government programs also on file: Medicaid.

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 543), 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 St Claire Regional 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 St Claire Regional Medical Center

Compare: Inguinal hernia repair at other KY hospitals

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