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Illinois

Cost of a Hernia Repair Visit
in Illinois

Reviewed by Momentary Medical Group West PC

Illinois healthcare costs run approximately 10% above national averages, reflecting the state's concentration of advanced medical facilities in the Chicago metro area. For Hernia Repair visits, patients typically pay between $90 and $1,569, with a median negotiated rate of $707 across the state's 4,730 active providers. Illinois residents can browse all Hernia Repair providers to compare costs and find in-network options.

Average

$789

Median

$707

Lowest

$90

Highest

$1,569

Providers

4,730

National avg: $843Illinois: $789

6% below national average

Compare Similar Procedures

How does inguinal hernia repair compare to related procedures in Illinois?

ProcedureCPTLowMedianHighProviders
Knee Replacement

Total knee replacement (arthroplasty)

27447$85$1,778$3,7894,831
Hip Replacement

Total hip replacement (arthroplasty)

27130$85$1,664$3,7074,966
Cataract Surgery

Cataract extraction with intraocular lens insertion

66984$418$694$1,2003,854
Knee Arthroscopy

Arthroscopy of the knee with meniscectomy

29881$90$655$1,8954,839
Gallbladder Removal (Laparoscopic)

Laparoscopic cholecystectomy

47562$85$943$1,9844,987
Appendectomy (Laparoscopic)

Laparoscopic appendectomy

44970$85$857$1,6546,834
Hysterectomy (Laparoscopic)

Laparoscopic total hysterectomy

58571$85$1,214$2,6655,065
Septoplasty

Nasal septum repair

30520$512$683$1,2893,659
Tonsillectomy

Tonsillectomy, primary or secondary

42820$253$339$5963,648
Mastectomy

Partial or simple mastectomy

19301$90$740$1,8464,743
Carpal Tunnel Surgery

Open carpal tunnel release

64721$372$594$1,0703,849

Important: These are cost estimates only — not a quote and not medical advice.

The prices on this page are self-pay rates, drawn from federal Transparency in Coverage machine-readable files (CPT 49505Repair initial inguinal hernia, age 5 or older). They represent what a patient might pay without insurance.

Your actual cost depends on: your specific insurance plan, your remaining deductible, your coinsurance percentage, whether you have met your out-of-pocket maximum, whether the facility and provider are both in-network, and any separate anesthesia or implant fees billed independently.

This page does not constitute medical advice. Whether you need this procedure, and which approach is right for you, is a decision to make with a licensed healthcare provider.

Where this data comes from & what CPT 49505 covers

Data source: Cost figures are derived from UnitedHealthcare Transparency in Coverage machine-readable files for CPT code 49505 (Repair initial inguinal hernia, age 5 or older), as mandated by the CMS Price Transparency Rule.

What CPT 49505 covers: the provider's professional fee for inguinal hernia repair. It does not include facility/hospital fees, anesthesia, pre-operative imaging, post-operative care, or any add-on codes billed separately.

How to read this data

Negotiated Rate

The discounted price an insurer has agreed to pay a specific provider. Most insured patients' bills are calculated from this number, not the higher list price hospitals publish separately.

P5, Median, P95

P5 is the rate at the 5th percentile (low end), Median is the middle value, and P95 is the 95th percentile (high end). This range shows how much the same visit can vary between providers.

What this does not tell you

These rates do not tell you what you personally will pay out of pocket. That depends on your specific plan, how much of your deductible you have already met, your coinsurance rate, and whether the provider is in your network. Call your insurer's member line to get your exact estimate.

Top-Rated Hospitals in Illinois

These hospitals in Illinois are top-rated for patient satisfaction. Review data sourced from HCAHPS Patient Survey.

5/5
96% would recommend133 patient surveys
5/5
91% would recommend122 patient surveys
MEMORIAL HOSPITAL

CARTHAGE, IL

5/5
87% would recommend114 patient surveys
5/5
79% would recommend117 patient surveys
5/5
78% would recommend107 patient surveys

Hospital ratings are based on HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey data published by CMS.

Why Hernia Repair Visit Costs Vary Across Illinois

Healthcare costs in Illinois run roughly 10% above national averages, driven by Chicago's concentration of academic medical centers and suburban surgical facilities. The state's mix of urban premium markets and rural value-based care creates significant geographic cost variations for hernia repairs.

Urban vs. Rural Provider Availability

Chicago and its suburbs host numerous fellowship-trained hernia specialists and robotic surgery programs, while rural Illinois relies more on general surgeons who perform hernia repairs alongside other procedures. This concentration drives higher costs in the metro area but also provides access to advanced minimally invasive techniques. Rural patients often travel to larger cities for complex or recurrent hernia repairs.

Facility Type and Overhead Costs

Hospital-owned outpatient surgery centers in Illinois typically charge more than independent surgical facilities due to higher overhead and facility fees. Major health systems like Northwestern Medicine, Advocate Aurora Health, and OSF HealthCare operate extensive networks that may offer negotiated rates with insurers. Independent surgery centers often provide more transparent pricing and cash-pay discounts.

Insurance Market Competition in Illinois

Competition between Blue Cross Blue Shield of Illinois, UnitedHealthcare, and Aetna creates moderate downward pressure on hernia repair costs compared to less competitive markets. The state's robust employer insurance market and Medicaid managed care contracts provide surgeons with steady patient volume. This competition particularly benefits patients in the Chicago metro area where provider density is highest.

Physician Supply and Demand in Illinois

With 4,730 active providers performing hernia repairs across Illinois, the state maintains adequate surgical capacity for most regions. This supply concentration in urban areas keeps wait times reasonable and provides patients with multiple provider options. Rural counties may have fewer specialists, potentially affecting both access and pricing for complex hernia cases.

JP

Jayant Panwar

CEO, Momentary Labs · San Francisco, CA

Jayant has analyzed healthcare pricing data from CMS Transparency in Coverage files since 2022, covering more than 50 million negotiated rate records across all 50 states. His work focuses on making insurer machine-readable files accessible to patients and researchers.

The cost figures on this page reflect his ongoing work to make this data accessible to patients.

Healthcare Data AnalyticsCMS TiC DataInsurance Price Transparency

Frequently Asked Questions — Hernia Repair Costs in Illinois

What is the average cost of a Hernia Repair visit in Illinois without insurance?

Hernia repair consultations in Illinois range from $90 to $1,569 for uninsured patients, with a median cost of $707 based on negotiated insurance rates. Self-pay patients often receive discounts of 30-50% off these rates, especially at independent surgical practices. Many providers offer payment plans to make the consultation and potential surgery more affordable.

Does Illinois Medicaid cover Hernia Repair visits?

Yes, Illinois expanded Medicaid covers hernia repair consultations and surgery through managed care organizations that contract with most general surgeons statewide. Patients typically need referrals from their primary care providers and may require prior authorization for certain advanced techniques like robotic repair. Coverage includes both the consultation and necessary imaging studies when medically appropriate.

How do I find an affordable Hernia Repair near me in Illinois?

Compare costs between hospital-based surgical clinics and independent surgery centers, as independents often charge significantly less. Ask about self-pay discounts, which many Illinois providers offer to uninsured patients, and consider traveling to rural areas where costs are typically lower. Community health centers and federally qualified health centers may also provide sliding-scale pricing based on income.

What is the difference in cost between an initial consultation and a follow-up visit?

Initial hernia consultations typically cost between $90-$1,569 with a median of $707, while follow-up visits generally run 30-50% less than new patient consultations. The initial visit includes comprehensive evaluation, physical examination, and surgical planning, while follow-ups focus on post-operative care or monitoring. Most insurance plans cover both types of visits with similar copay structures.

Can I use an HSA or FSA to pay for a Hernia Repair visit in Illinois?

Yes, both HSA and FSA funds can be used for hernia repair consultations and surgery as they qualify as necessary medical expenses under IRS guidelines. This includes the surgeon consultation, diagnostic imaging, and the actual repair procedure. Keep all receipts and documentation for tax purposes, as these accounts require proper medical expense verification.

How does telemedicine affect the cost of seeing a Hernia Repair in Illinois?

While initial hernia evaluations require in-person physical examination to assess the bulge and determine surgical candidacy, telemedicine can reduce costs for pre-operative consultations and some follow-up visits. Illinois has expanded telehealth coverage since 2020, with most insurers covering virtual consultations at the same rate as office visits. However, the physical examination component of hernia evaluation cannot be completed remotely.

Click a state to compare costs

Average Visit Cost

$337
$1,784

Office visit (CPT 49505)

Compare With Other States

RankStateAverage
1Wisconsin
Range: $73$4,031
$1,784
2Iowa
Range: $457$2,449
$1,346
3Alaska
Range: $440$2,338
$1,154
4Massachusetts
Range: $397$2,168
$1,133
5Montana
Range: $378$2,328
$1,120
6Georgia
Range: $421$1,969
$1,097
7South Dakota
Range: $439$2,034
$1,081
8Wyoming
Range: $628$1,642
$1,050
9New Hampshire
Range: $504$1,521
$1,002
10Nebraska
Range: $637$1,214
$994
11Washington
Range: $592$1,594
$984
12Minnesota
Range: $344$1,787
$970
13Rhode Island
Range: $440$1,521
$940
14North Dakota
Range: $437$1,537
$894
15Maine
Range: $630$1,022
$883
16Utah
Range: $374$1,150
$883
17California
Range: $423$1,216
$871
18Oregon
Range: $440$1,399
$866
19North Carolina
Range: $426$1,453
$859
20District of Columbia
Range: $381$1,221
$834
21Connecticut
Range: $368$1,435
$824
22New Mexico
Range: $465$1,226
$821
23West Virginia
Range: $381$1,378
$806
24Missouri
Range: $493$1,027
$804
25Colorado
Range: $441$1,242
$798
26Michigan
Range: $440$1,216
$797
27Delaware
Range: $330$1,435
$789
28Illinois
Range: $90$1,569
$789
29Pennsylvania
Range: $333$1,448
$781
30Idaho
Range: $438$1,197
$775
31Hawaii
Range: $426$1,149
$769
32New York
Range: $364$1,435
$768
33Kentucky
Range: $396$1,220
$763
34Vermont
Range: $391$1,271
$753
35Arkansas
Range: $461$1,043
$746
36New Jersey
Range: $309$1,435
$740
37Indiana
Range: $90$1,448
$722
38Mississippi
Range: $409$1,251
$718
39Tennessee
Range: $440$1,016
$705
40South Carolina
Range: $391$1,170
$705
41Texas
Range: $407$1,086
$699
42Alabama
Range: $356$1,111
$688
43Louisiana
Range: $383$1,052
$681
44Kansas
Range: $493$872
$667
45Virginia
Range: $358$1,079
$664
46Maryland
Range: $381$1,079
$653
47Oklahoma
Range: $429$991
$647
48Ohio
Range: $328$1,039
$638
49Nevada
Range: $423$859
$596
50Arizona
Range: $432$882
$585
51Florida
Range: $35$920
$337
Inguinal Hernia Repair in Other States