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New York

Cost of a Hernia Repair Visit
in New York

Reviewed by Momentary Medical Group West PC

New York's healthcare costs run approximately 22% above national averages, driven by the state's concentration of academic medical centers and urban provider density. Hernia Repair visits in New York typically range from $364 to $1,435, with a median negotiated rate of $504 based on Transparency in Coverage data. With over 30,000 active Hernia Repair providers throughout the state, patients have extensive options across New York's diverse healthcare landscape.

Average

$768

Median

$504

Lowest

$364

Highest

$1,435

Providers

30,842

National avg: $843New York: $768

9% below national average

Compare Similar Procedures

How does inguinal hernia repair compare to related procedures in New York?

ProcedureCPTLowMedianHighProviders
Knee Replacement

Total knee replacement (arthroplasty)

27447$898$1,288$6,05130,852
Hip Replacement

Total hip replacement (arthroplasty)

27130$900$1,289$6,06030,927
Cataract Surgery

Cataract extraction with intraocular lens insertion

66984$364$515$2,13530,876
Knee Arthroscopy

Arthroscopy of the knee with meniscectomy

29881$384$538$2,41030,865
Gallbladder Removal (Laparoscopic)

Laparoscopic cholecystectomy

47562$452$638$1,82030,954
Appendectomy (Laparoscopic)

Laparoscopic appendectomy

44970$412$577$1,65531,025
Hysterectomy (Laparoscopic)

Laparoscopic total hysterectomy

58571$627$890$3,20130,796
Septoplasty

Nasal septum repair

30520$466$625$2,16030,844
Tonsillectomy

Tonsillectomy, primary or secondary

42820$203$276$74230,860
Mastectomy

Partial or simple mastectomy

19301$452$609$2,64230,775
Carpal Tunnel Surgery

Open carpal tunnel release

64721$320$622$1,96330,846

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 New York

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

5/5
87% would recommend116 patient surveys
5/5
84% would recommend532 patient surveys
4/5
88% would recommend927 patient surveys
4/5
87% would recommend118 patient surveys
4/5
85% would recommend2,396 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 New York

New York's healthcare costs exceed national averages by approximately 22%, reflecting the state's concentration of prestigious medical institutions and high urban operating expenses. The dramatic cost differential between Manhattan's academic medical centers and upstate community hospitals creates significant pricing variation within a single state market.

Urban vs. Rural Provider Availability

Manhattan and Long Island's dense surgical networks contrast sharply with limited specialist access in the North Country and Southern Tier regions. Patients in rural counties like Hamilton or Essex may travel 100+ miles for specialized hernia repair services, often requiring overnight stays that increase total costs. The Adirondack and Finger Lakes regions rely heavily on regional medical centers in Albany and Syracuse for complex surgical care.

Facility Type and Overhead Costs

Hospital-owned practices affiliated with NYU Langone, Mount Sinai, and NewYork-Presbyterian carry premium facility fees due to their Manhattan real estate costs and academic missions. Independent surgical centers in suburban markets like Nassau County and Westchester operate with lower overhead while maintaining similar quality outcomes. Ambulatory surgery centers throughout the state offer cost-effective alternatives to hospital-based consultations and procedures.

Insurance Market Competition in New York

Strong competition between Empire BCBS, UHC, Aetena, and Cigna creates varied negotiated rate structures across different health plans and employer groups. The state's large employer market drives competitive rates in metropolitan areas, while rural regions may have limited insurer participation. Medicaid managed care organizations maintain separate rate structures that often reimburse providers below commercial insurance levels.

Physician Supply and Demand in New York

With over 30,000 active Hernia Repair providers, New York maintains robust surgical capacity concentrated in urban corridors from New York City to Albany and Buffalo. This substantial supply helps moderate pricing in competitive markets, though demand remains high due to the state's aging population and obesity rates. Wait times for non-urgent surgical consultations typically range from 2-6 weeks in metropolitan areas, extending to several months in rural regions with limited specialist coverage.

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 New York

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

Uninsured patients in New York typically pay between $364 and $1,435 for hernia repair consultations, with a median cost of $504 based on negotiated rate data. Cash-pay discounts of 15-30% are commonly available, bringing costs down to $350-500 for most patients. Many surgical practices offer payment plans to help manage these expenses over time.

Does New York Medicaid cover Hernia Repair visits?

Yes, New York's expanded Medicaid program covers surgical consultations for hernia repair with minimal patient cost-sharing. Coverage includes both initial evaluations and follow-up visits, along with necessary imaging studies and surgical procedures when medically indicated. Nearly 6 million New Yorkers benefit from this comprehensive Medicaid coverage, providing crucial access to specialized surgical care.

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

Compare costs between independent surgical centers and hospital-based practices, as ambulatory surgery centers often charge 30-40% less than academic medical centers. Community health centers throughout New York offer sliding-scale fees based on income, while many practices provide cash-pay discounts for uninsured patients. Rural and suburban providers typically cost less than Manhattan specialists while maintaining similar quality outcomes.

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

Initial hernia repair consultations typically cost $364-$1,435 with a median of $504, as these involve comprehensive evaluation and surgical planning. Follow-up visits generally cost significantly less, usually ranging from $100-300 depending on complexity and whether additional imaging or procedures are required. Most insurance plans cover both types of visits similarly, though copays may vary between new and established patient encounters.

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

Yes, both HSA and FSA funds can be used for hernia repair consultations and related medical expenses as qualified medical expenses under IRS guidelines. This includes surgeon fees, facility charges, and any necessary imaging studies ordered during your evaluation. Keep all receipts and documentation for tax purposes, as these pre-tax dollars provide significant savings on out-of-pocket medical costs.

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

Telemedicine consultations for hernia evaluation typically cost 40-60% less than in-person visits, though physical examination limitations may require subsequent office visits for definitive assessment. New York's robust telehealth infrastructure expanded significantly during COVID-19, with most major health systems offering virtual consultations. However, surgical planning and pre-operative evaluations usually require in-person assessment for optimal patient safety and surgical outcomes.

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