CMS Price Transparency Data

Inguinal hernia repair

Facility: The University of Vermont Health Network-Alice Hy

Billing Code: 49505 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$764

about 0.2× the $3,658 Medicare rate · typically $467–$3,224

modeled estimate · not a bill or quote

What this hospital charges insurers

$509

Below the fair price — a good deal

about $255 under the fair price · 0.1× Medicare

Medicare pays $3,658 Fair price $764 This hospital $509 Cash price $1,574 Hospital's list price $1,574

How we calculate the fair BaseRate →

How this hospital compares to other NY hospitals

One of the lower prices — 7 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.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Inguinal hernia repair is about $764 (about 0.2× the $3,658 Medicare rate). The University of Vermont Health Network-Alice Hy charges insurers about $509, or about $1,574 in cash — below the fair price — a good deal. Located in Malone, 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✓ Humana CignaKaiser 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	$342 - $9,020	9%
Blue Cross Blue Shieldmajor	$403 - $11,420	11%
Aetnamajor	$488 - $751	13%
Humanamajor	$415	11%
Fidelis Care	$415 - $562	11%
MagnaCare	$1,259	34%
MVP Health Care	$415 - $1,122	11%
+ 4 smaller / regional plans	$332 - $1,022

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 1,574), 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 The University of Vermont Health Network-Alice Hy 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 The University of Vermont Health Network-Alice Hy

Compare: Inguinal hernia repair at other NY hospitals

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