CMS Price Transparency Data

Inguinal hernia repair

Facility: Great Falls Clinic Hospital

Billing Code: 49505 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$5,422

about 1.5× the $3,658 Medicare rate · typically $3,533–$7,807

modeled estimate · not a bill or quote

What this hospital charges insurers

$6,916

Above the fair price

about $1,494 over the fair price · 1.9× Medicare

Medicare pays $3,658 Fair price $5,422 This hospital $6,916 Cash price $19,456 Hospital's list price $19,456

How we calculate the fair BaseRate →

How this hospital compares to other MT hospitals

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

Cheapest $760 Priciest $6,916

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

A fair price for a Inguinal hernia repair is about $5,422 (about 1.5× the $3,658 Medicare rate). Great Falls Clinic Hospital charges insurers about $6,916, or about $19,456 in cash — above the fair price. Located in Great Falls, MT.

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 $5,422. 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.

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

✓ Blue Cross Blue Shield✓ Humana UnitedHealthcareAetnaCignaKaiser 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	$3,640 - $8,190	100%
Humanamajor	$3,640	100%
+ 2 smaller / regional plans	$6,916 - $8,008

Government programs also on file: Military & VA.

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 19,456), 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 Great Falls Clinic 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 Great Falls Clinic Hospital

Compare: Inguinal hernia repair at other MT hospitals

Frances Mahon Deaconess Hospital · Glasgow $760
Central Montana Medical Center · Lewistown $821
Livingston Healthcare · Livingston $832
Barrett Hospital & Healthcare · Dillon $840
Sidney Health Center · Sidney $851
St Peters Health · Helena $3,620
St James Hospital · Butte $3,635
St. Patrick Hospital · Missoula $3,768

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