CMS Price Transparency Data

Inguinal hernia repair

Facility: Holyoke Medical Center

Billing Code: 49505 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$4,174

about 1.1× the $3,658 Medicare rate · typically $2,606–$4,709

modeled estimate · not a bill or quote

Medicare pays $3,658 Fair price $4,174 Cash price $3,066 Hospital's list price $3,832

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser 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	$3,716 - $4,032	102%
Blue Cross Blue Shieldmajor	$3,716 - $4,752	102%
Aetnamajor	$3,716	102%
Cignamajor	$4,780	131%
Harvard Pilgrim	$4,032	110%
Tufts Health Plan	$1,512 - $6,137	41%
WellCare	$3,975	109%
WellSense	$3,938 - $5,505	108%
+ 4 smaller / regional plans	$3,716 - $4,404

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 3,066), 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 Holyoke 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 Holyoke Medical Center

Compare: Inguinal hernia repair at other MA hospitals

Metrowest Medical Center · Framingham $1,371
St Vincent Hospital · Worcester $1,371
The Shriners' Hospital for Children - Boston · Boston $3,136
Cambridge Health Alliance · Cambridge $3,370
Beth Israel Deaconess Hospital - Milton · Milton $3,627
Emerson Hospital - · W Concord $3,658
South Shore Hospital · South Weymouth $3,831
Milford Regional Medical Center · Milford $3,837

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