CMS Price Transparency Data

Inguinal hernia repair

Facility: Garnet Health Medical Center

Billing Code: 49505 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$4,910

about 1.3× the $3,658 Medicare rate · typically $3,351–$9,224

modeled estimate · not a bill or quote

What this hospital charges insurers

$4,148

Below the fair price — a good deal

about $762 under the fair price · 1.1× Medicare

Medicare pays $3,658 Fair price $4,910 This hospital $4,148

How we calculate the fair BaseRate →

How this hospital compares to other NY hospitals

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

Cheapest $491 Priciest $4,148

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 $4,910 (about 1.3× the $3,658 Medicare rate). Garnet Health Medical Center charges insurers about $4,148 — below the fair price — a good deal. Located in Middletown, NY.

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	$3,262	89%
Blue Cross Blue Shieldmajor	$5,377 - $5,501	147%
Aetnamajor	$2,245 - $4,469	61%
Cignamajor	$5,386	147%
CDPHP	$6,647	182%
Fidelis Care	$4,559	125%
Geisinger	$11,173	305%
MagnaCare	$1,517 - $2,427	41%
MVP Health Care	$2,653	73%
WellCare	$4,572	125%
+ 4 smaller / regional plans	$2,245 - $9,162

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, 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 Garnet Health 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 Garnet Health Medical Center

Compare: Inguinal hernia repair at other NY hospitals

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