CMS Price Transparency Data

Inguinal hernia repair

Facility: Essentia Health St Mary's Medical Center

Billing Code: 49505 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$3,550

about 1.0× the $3,658 Medicare rate · typically $1,538–$3,671

modeled estimate · not a bill or quote

What this hospital charges insurers

$3,539

About the fair price

about $11 under the fair price · 1.0× Medicare

Medicare pays $3,658 Fair price $3,550 This hospital $3,539 Cash price $2,866 Hospital's list price $4,342

How we calculate the fair BaseRate →

How this hospital compares to other MN hospitals

Highest price of the 9 MN hospitals we have prices for — worth calling around.

Cheapest $465 Priciest $3,539

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

A fair price for a Inguinal hernia repair is about $3,550 (about 1.0× the $3,658 Medicare rate). Essentia Health St Mary's Medical Center charges insurers about $3,539, or about $2,866 in cash — about the fair price. Located in Duluth, MN.

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	$3,178 - $3,539	87%
Blue Cross Blue Shieldmajor	$1,917 - $7,980	52%
Aetnamajor	$3,691	101%
Cignamajor	$3,105	85%
HealthPartners	$1,728 - $3,539	47%
Medica	$1,437 - $3,539	39%
Sanford Health Plan	$1,862 - $6,249	51%
Security Health Plan	$3,343 - $3,539	91%
UCare	$2,857 - $3,539	78%
+ 15 smaller / regional plans	$1,917 - $3,734

Government programs also on file: Medicare.

Excludes 2 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 2,866), 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 Essentia Health St Mary's 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 Essentia Health St Mary's Medical Center

Compare: Inguinal hernia repair at other MN hospitals

Ely - Bloomenson Community Hospital · Ely $465
Chippewa County Hospital · Montevideo $465
Perham Health · Perham $465
Madison Hospital · Madison $467
Windom Area Health · Windom $475
Astera Health · Wadena $475
Lakewood Health System · Staples $500
Lifecare Medical Center · Roseau $570

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