CMS Price Transparency Data

Inguinal hernia repair

Facility: Penn State Health St. Joseph

Billing Code: 49505 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$2,996

about 0.8× the $3,658 Medicare rate · typically $556–$3,786

modeled estimate · not a bill or quote

What this hospital charges insurers

$3,641

Above the fair price

about $645 over the fair price · 1.0× Medicare

Medicare pays $3,658 Fair price $2,996 This hospital $3,641 Cash price $5,966 Hospital's list price $22,939

How we calculate the fair BaseRate →

How this hospital compares to other PA hospitals

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

Cheapest $482 Priciest $3,641

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

A fair price for a Inguinal hernia repair is about $2,996 (about 0.8× the $3,658 Medicare rate). Penn State Health St. Joseph charges insurers about $3,641, or about $5,966 in cash — above the fair price. Located in Reading, PA.

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 $2,996. 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	$3,641 - $15,530	100%
Blue Cross Blue Shieldmajor	$3,095 - $19,792	85%
Aetnamajor	$3,678 - $11,716	101%
Cignamajor	$14,073	385%
Humanamajor	$3,678	101%
AmeriHealth	$3,095 - $3,641	85%
Cigna HealthSpring	$3,678	101%
Geisinger	$3,277 - $16,548	90%
HealthPartners	$3,387 - $3,714	93%
UPMC Health Plan	$3,714 - $16,947	102%
+ 3 smaller / regional plans	$3,405 - $11,401

Excludes 3 rental-network / third-party entries (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 5,966), 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 Penn State Health St. Joseph 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 Penn State Health St. Joseph

Compare: Inguinal hernia repair at other PA hospitals

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