CMS Price Transparency Data

Inguinal hernia repair

Facility: St Mary's General Hospital

Billing Code: 49505 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$4,653

about 1.3× the $3,658 Medicare rate · typically $3,844–$5,780

modeled estimate · not a bill or quote

What this hospital charges insurers

$5,353

Above the fair price

about $700 over the fair price · 1.5× Medicare

Medicare pays $3,658 Fair price $4,653 This hospital $5,353 Cash price $4,232 Hospital's list price $28,702

How we calculate the fair BaseRate →

How this hospital compares to other NJ hospitals

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

Cheapest $860 Priciest $5,353

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

A fair price for a Inguinal hernia repair is about $4,653 (about 1.3× the $3,658 Medicare rate). St Mary's General Hospital charges insurers about $5,353, or about $4,232 in cash — above the fair price. Located in Passaic, NJ.

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 $4,653. 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	$4,233 - $5,709	116%
Blue Cross Blue Shieldmajor	$4,233	116%
Aetnamajor	$4,233 - $8,973	116%
Cignamajor	$6,220	170%
Humanamajor	$3,386	93%
AmeriHealth	$4,233	116%
Clover Health	$4,233	116%
WellCare	$4,233 - $5,714	116%
+ 5 smaller / regional plans	$1,715 - $7,505

Government programs also on file: Medicare, 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 4,232), 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 Mary's General 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 St Mary's General Hospital

Compare: Inguinal hernia repair at other NJ hospitals

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