CMS Price Transparency Data

Inguinal hernia repair

Facility: Progress West Hospital

Billing Code: 49505 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$3,458

about 0.9× the $3,658 Medicare rate · typically $2,466–$6,731

modeled estimate · not a bill or quote

What this hospital charges insurers

$7,193

Well above the fair price

about $3,735 over the fair price · 2.0× Medicare

Medicare pays $3,658 Fair price $3,458 This hospital $7,193 Cash price $12,803 Hospital's list price $21,338

How we calculate the fair BaseRate →

How this hospital compares to other MO hospitals

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

Cheapest $385 Priciest $7,193

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

A fair price for a Inguinal hernia repair is about $3,458 (about 0.9× the $3,658 Medicare rate). Progress West Hospital charges insurers about $7,193, or about $12,803 in cash — well above the fair price. Located in Ofallon, MO.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $3,458. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

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	$7,193	197%
Blue Cross Blue Shieldmajor	$5,558 - $7,630	152%
Aetnamajor	$3,586 - $9,085	98%
Cignamajor	$5,710 - $10,962	156%
Humanamajor	$6,690	183%
Priority Health	$10,962	300%
+ 9 smaller / regional plans	$4,697 - $10,962

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 12,803), 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 Progress West Hospital 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 Progress West Hospital

Compare: Inguinal hernia repair at other MO hospitals

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