CMS Price Transparency Data

Inguinal hernia repair

Facility: Riverview Medical Center

Billing Code: 49505 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$4,418

about 1.2× the $3,658 Medicare rate · typically $4,057–$5,707

modeled estimate · not a bill or quote

What this hospital charges insurers

$4,553

About the fair price

about $135 over the fair price · 1.2× Medicare

Medicare pays $3,658 Fair price $4,418 This hospital $4,553 Cash price $3,906 Hospital's list price $9,680

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 $4,553

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 $4,418 (about 1.2× the $3,658 Medicare rate). Riverview Medical Center charges insurers about $4,553, or about $3,906 in cash — about the fair price. Located in Red Bank, NJ.

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	$1,189 - $14,048	33%
Blue Cross Blue Shieldmajor	$2,110 - $3,906	58%
Aetnamajor	$1,365 - $8,419	37%
Cignamajor	$4,418 - $7,744	121%
AmeriHealth	$8,371 - $9,482	229%
Clover Health	$1,742	48%
WellCare	$3,906	107%
+ 8 smaller / regional plans	$1,091 - $11,277

Government programs also on file: Military & VA.

Excludes 1 rental-network / third-party entry (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 3,906), 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 Riverview 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 Riverview Medical Center

Compare: Inguinal hernia repair at other NJ hospitals

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