CMS Price Transparency Data

Inguinal hernia repair

Facility: UPMC Presbyterian Shadyside

Billing Code: 49505 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$2,772

about 0.8× the $3,658 Medicare rate · typically $1,124–$3,643

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,348

Below the fair price — a good deal

about $1,424 under the fair price · 0.4× Medicare

Medicare pays $3,658 Fair price $2,772 This hospital $1,348 Cash price $8,450 Hospital's list price $14,084

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 $1,348

Black dot = this hospital, among the 9 PA 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 $2,772 (about 0.8× the $3,658 Medicare rate). UPMC Presbyterian Shadyside charges insurers about $1,348, or about $8,450 in cash — below the fair price — a good deal. Located in Pittsburgh, PA.

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	$967 - $3,634	26%
Blue Cross Blue Shieldmajor	$471 - $7,096	13%
Aetnamajor	$413 - $3,701	11%
Cignamajor	$3,634	99%
Humanamajor	$11,971	327%
AmeriHealth	$502 - $3,634	14%
Fidelis Care	$10,563	289%
Geisinger	$494	14%
HealthPartners	$479	13%
UPMC Health Plan	$349 - $1,237	10%
+ 6 smaller / regional plans	$541 - $11,971

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 8,450), 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 Presbyterian Shadyside 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 Presbyterian Shadyside

Compare: Inguinal hernia repair at other PA hospitals

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