CMS Price Transparency Data

Inguinal hernia repair

Facility: Forbes Hospital

Billing Code: 49505 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$546

about 0.1× the $3,658 Medicare rate · typically $523–$1,472

modeled estimate · not a bill or quote

What this hospital charges insurers

$564

About the fair price

about $18 over the fair price · 0.2× Medicare

Medicare pays $3,658 Fair price $546 This hospital $564 Cash price $326 Hospital's list price $1,481

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 $564

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 $546 (about 0.1× the $3,658 Medicare rate). Forbes Hospital charges insurers about $564, or about $326 in cash — about the fair price. Located in Monroeville, 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	$92 - $10,725	3%
Blue Cross Blue Shieldmajor	$88 - $6,636	2%
Aetnamajor	$76 - $9,676	2%
Cignamajor	$837 - $9,913	23%
Humanamajor	$3,599	98%
AmeriHealth	$67 - $3,565	2%
Geisinger	$92 - $1,290	3%
Medical Mutual	$9,913	271%
Molina	$3,701	101%
+ 6 smaller / regional plans	$53 - $8,866

Government programs also on file: Medicare.

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 326), 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 Forbes Hospital 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 Forbes Hospital

Compare: Inguinal hernia repair at other PA hospitals

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