CMS Price Transparency Data

Inguinal hernia repair

Facility: UPMC Pinnacle Hospitals

Billing Code: 49505 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$3,619

about 1.0× the $3,658 Medicare rate · typically $3,001–$4,047

modeled estimate · not a bill or quote

Medicare pays $3,658 Fair price $3,619 Cash price $1,697 Hospital's list price $2,828

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	$1,056 - $3,714	29%
Blue Cross Blue Shieldmajor	$3,437 - $9,756	94%
Aetnamajor	$3,621 - $5,681	99%
Cignamajor	$3,645	100%
Humanamajor	$3,576	98%
AmeriHealth	$429	12%
Geisinger	$462	13%
HealthPartners	$432	12%
UPMC Health Plan	$1,119 - $3,251	31%
+ 3 smaller / regional plans	$541 - $9,756

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 1,697), 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 UPMC Pinnacle Hospitals 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 UPMC Pinnacle Hospitals

Compare: Inguinal hernia repair at other PA hospitals

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