CMS Price Transparency Data

Inguinal hernia repair

Facility: Kenmore Mercy Hospital

Billing Code: 49505 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$454

about 0.1× the $3,658 Medicare rate · typically $323–$1,067

modeled estimate · not a bill or quote

What this hospital charges insurers

$524

Above the fair price

about $70 over the fair price · 0.1× Medicare

Medicare pays $3,658 Fair price $454 This hospital $524 Cash price $1,491 Hospital's list price $1,491

How we calculate the fair BaseRate →

How this hospital compares to other NY hospitals

One of the lower prices — 6 of 8 other NY hospitals charge more for the same procedure.

Cheapest $491 Priciest $570

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

A fair price for a Inguinal hernia repair is about $454 (about 0.1× the $3,658 Medicare rate). Kenmore Mercy Hospital charges insurers about $524, or about $1,491 in cash — above the fair price. Located in Kenmore, NY.

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 $454. 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	$56 - $851	2%
Blue Cross Blue Shieldmajor	$74 - $912	2%
Aetnamajor	$524 - $786	14%
Cignamajor	$68 - $1,085	2%
Humanamajor	$449 - $786	12%
Amerigroup	$234 - $351	6%
Fidelis Care	$469 - $898	13%
Independent Health	$199 - $894	5%
Molina	$526 - $789	14%
MVP Health Care	$545 - $962	15%
UPMC Health Plan	$898 - $1,347	25%
WellCare	$466 - $823	13%
+ 16 smaller / regional plans	$68 - $1,704

Government programs also on file: Medicare, Medicaid, 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 1,491), 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 Kenmore Mercy 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 Kenmore Mercy Hospital

Compare: Inguinal hernia repair at other NY hospitals

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