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Massachusetts

Cost of a Hernia Repair Visit
in Massachusetts

Reviewed by Momentary Medical Group West PC

Massachusetts maintains one of the highest concentrations of academic medical centers in the nation, creating a competitive landscape for specialized surgical care including Hernia Repair procedures. Patients typically pay between $397 and $2,168 for Hernia Repair services, with a median cost of $834 based on negotiated insurance rates. The state's over 1,000 active Hernia Repair providers offer patients multiple options for finding quality care within their network and budget across Massachusetts.

Average

$1,133

Median

$834

Lowest

$397

Highest

$2,168

Providers

1,003

National avg: $843Massachusetts: $1,133

35% above national average

Compare Similar Procedures

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

ProcedureCPTLowMedianHighProviders
Knee Replacement

Total knee replacement (arthroplasty)

27447$1,061$2,196$6,0511,004
Hip Replacement

Total hip replacement (arthroplasty)

27130$80$2,012$6,0601,302
Cataract Surgery

Cataract extraction with intraocular lens insertion

66984$403$935$2,0781,014
Knee Arthroscopy

Arthroscopy of the knee with meniscectomy

29881$438$892$2,4101,023
Gallbladder Removal (Laparoscopic)

Laparoscopic cholecystectomy

47562$476$1,057$2,7171,072
Appendectomy (Laparoscopic)

Laparoscopic appendectomy

44970$80$834$2,4851,368
Hysterectomy (Laparoscopic)

Laparoscopic total hysterectomy

58571$710$1,297$3,8901,012
Septoplasty

Nasal septum repair

30520$456$1,001$2,7881,010
Tonsillectomy

Tonsillectomy, primary or secondary

42820$219$455$1,2371,012
Mastectomy

Partial or simple mastectomy

19301$350$988$2,4081,009
Carpal Tunnel Surgery

Open carpal tunnel release

64721$338$721$1,9571,008

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 Massachusetts

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

FAIRVIEW HOSPITAL

GREAT BARRINGTON, MA

5/5
94% would recommend164 patient surveys
5/5
89% would recommend929 patient surveys
5/5
86% would recommend174 patient surveys
4/5
88% would recommend382 patient surveys
4/5
87% would recommend593 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 Massachusetts

Massachusetts healthcare costs run approximately 20% above national averages, driven by the state's concentration of prestigious academic medical centers and highly trained specialists. The Commonwealth's compact geography creates intense competition among world-renowned institutions like Mass General, Brigham and Women's, and Boston Medical Center.

Urban vs. Rural Provider Availability

The Boston metropolitan area contains the majority of Massachusetts's surgical specialists, creating significant access advantages for urban patients compared to those in western Massachusetts counties. Rural patients often travel to Springfield or Worcester for specialized hernia care, potentially adding travel costs to their overall treatment expenses. This geographic concentration can drive up demand and pricing in metropolitan surgical centers.

Facility Type and Overhead Costs

Hospital-based outpatient surgical centers in Massachusetts typically charge premium rates due to higher overhead costs and academic medical center affiliations. Independent ambulatory surgery centers offer competitive alternatives with potentially lower costs for routine hernia repairs. The dominance of Partners HealthCare (now Mass General Brigham) and other large health systems influences pricing throughout the state.

Insurance Market Competition in Massachusetts

The three major insurers - BCBS MA, Tufts Health Plan, and Harvard Pilgrim - control most of the Massachusetts market, creating limited competition that can affect negotiated rates. This consolidated market structure gives insurers significant bargaining power with providers, but also reduces patient choice in coverage options. Employer-sponsored plans dominate the market, influencing overall pricing strategies for surgical procedures.

Physician Supply and Demand in Massachusetts

With over 1,000 active Hernia Repair providers, Massachusetts has one of the highest surgeon-to-population ratios in the nation, particularly around Boston's academic medical corridor. This abundant supply typically moderates pricing and reduces wait times for non-urgent procedures. The concentration of fellowship-trained specialists drives quality but may increase costs compared to general surgeons performing similar procedures.

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 Massachusetts

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

Without insurance, patients in Massachusetts typically pay between $397 and $2,168 for Hernia Repair procedures, with a median cost of $834. These rates represent actual negotiated prices between insurers and providers, so uninsured patients may be able to negotiate similar rates or receive cash-pay discounts. Many facilities offer payment plans or financial hardship programs to help manage these costs.

Does Massachusetts Medicaid cover Hernia Repair visits?

Yes, Massachusetts expanded Medicaid comprehensively covers medically necessary Hernia Repair consultations and procedures when conservative treatments have failed or are inappropriate. Coverage includes both open and minimally invasive surgical techniques, with most patients paying minimal copays. Prior authorization may be required for certain surgical approaches or mesh materials, but urgent cases typically receive expedited approval.

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

Compare costs across different facility types, as independent surgery centers often charge less than hospital-based outpatient departments for routine hernia repairs. Ask about self-pay discounts if you're uninsured, and consider community health centers or academic medical centers that may offer sliding fee scales. Massachusetts has over 1,000 hernia specialists, giving you multiple options to compare pricing and find in-network providers.

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

Initial Hernia Repair consultations typically cost between $397 and $2,168 depending on the complexity of evaluation and facility type. Follow-up visits for established patients generally cost significantly less, often ranging from $150-400 for routine post-operative care. The actual surgical procedure represents the largest cost component, separate from consultation fees.

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

Yes, both HSA and FSA funds can be used for medically necessary Hernia Repair consultations, procedures, and related expenses in Massachusetts. These accounts can also cover associated costs like prescription medications, medical supplies, and transportation to medical appointments. Keep all receipts and documentation for tax purposes and account administration.

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

While initial hernia evaluations typically require in-person physical examination, telemedicine consultations for follow-up care or second opinions generally cost 20-40% less than office visits. Massachusetts insurers widely cover telehealth services, making remote consultations an affordable option for routine post-operative care. However, surgical procedures and detailed physical assessments still require in-person visits at traditional rates.

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