CMS Price Transparency Data

Inguinal hernia repair

Facility: Avita Ontario

Billing Code: 49505 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$3,333

about 0.9× the $3,658 Medicare rate · typically $3,333–$3,333

modeled estimate · not a bill or quote

Medicare pays $3,658 Fair price $3,333 Cash price $31,643 Hospital's list price $37,227

How we calculate the fair BaseRate →

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	$1,011 - $26,897	28%
Blue Cross Blue Shieldmajor	$1,011 - $26,543	28%
Aetnamajor	$3,658 - $37,227	100%
Cignamajor	$29,000	793%
Humanamajor	$1,011 - $3,658	28%
AmeriHealth	$1,011	28%
CareSource	$1,011	28%
Medical Mutual	$3,658 - $29,782	100%
Molina	$1,011 - $3,658	28%
+ 2 smaller / regional plans	$1,011 - $3,658

Government programs also on file: Medicare, Medicaid.

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 31,643), 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 Avita Ontario 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 Avita Ontario

Compare: Inguinal hernia repair at other OH hospitals

Southern Ohio Medical Center · Portsmouth $623
Fisher-Titus Hospital · Norwalk $661
Union Hospital · Dover $723
Genesis Hospital · Zanesville $743
Southwest General Health Center · Middleburg Heights $843
Mercy Medical Center · Canton $932
Galion Community Hospital · Galion $1,011
Henry County Hospital, Inc · Napoleon $1,251

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