Cost of a Hernia Repair Visit
in Pennsylvania
Reviewed by Momentary Medical Group West PC
Pennsylvania's healthcare market, anchored by major health systems in Philadelphia and Pittsburgh, offers patients access to 914 active Hernia Repair providers across the state. Based on negotiated insurance rates, patients typically pay between $332.76 and $1,448.40 for Hernia Repair services, with a median cost of $561.74. The state's expanded Medicaid program and competitive insurer landscape help moderate costs, though Pennsylvania still runs approximately 21% below national averages for this specialty.
Average
$781
Median
$562
Lowest
$333
Highest
$1,448
Providers
914
7% below national average
Compare Similar Procedures
How does inguinal hernia repair compare to related procedures in Pennsylvania?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Knee Replacement Total knee replacement (arthroplasty) | 27447 | $909 | $1,551 | $6,051 | 916 |
| Hip Replacement Total hip replacement (arthroplasty) | 27130 | $80 | $1,379 | $6,060 | 1,270 |
| Cataract Surgery Cataract extraction with intraocular lens insertion | 66984 | $85 | $618 | $2,135 | 984 |
| Knee Arthroscopy Arthroscopy of the knee with meniscectomy | 29881 | $366 | $623 | $2,410 | 933 |
| Gallbladder Removal (Laparoscopic) Laparoscopic cholecystectomy | 47562 | $98 | $709 | $1,984 | 1,021 |
| Appendectomy (Laparoscopic) Laparoscopic appendectomy | 44970 | $80 | $632 | $1,669 | 1,389 |
| Hysterectomy (Laparoscopic) Laparoscopic total hysterectomy | 58571 | $85 | $975 | $3,201 | 983 |
| Septoplasty Nasal septum repair | 30520 | $434 | $719 | $2,160 | 910 |
| Tonsillectomy Tonsillectomy, primary or secondary | 42820 | $149 | $317 | $742 | 968 |
| Mastectomy Partial or simple mastectomy | 19301 | $250 | $705 | $2,642 | 976 |
| Carpal Tunnel Surgery Open carpal tunnel release | 64721 | $317 | $537 | $1,957 | 914 |
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 49505 — Repair 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 Pennsylvania
These hospitals in Pennsylvania are top-rated for patient satisfaction. Review data sourced from HCAHPS Patient Survey.
WASHINGTON, PA
ROYERSFORD, PA
YORK, PA
WYOMISSING, PA
MUNCY, PA
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 Pennsylvania
Pennsylvania's healthcare costs run approximately 21% below national averages for Hernia Repair services, reflecting the state's competitive insurance market and balanced urban-rural provider distribution. The concentration of major health systems in Philadelphia and Pittsburgh creates pricing anchors that influence costs throughout the commonwealth.
Urban vs. Rural Provider Availability
Pennsylvania's 914 active Hernia Repair providers are heavily concentrated in the Philadelphia and Pittsburgh metropolitan areas, with rural counties often requiring patients to travel 60+ miles for specialized surgical care. This geographic disparity means rural patients may face higher total costs due to travel and time off work, despite potentially lower facility fees.
Facility Type and Overhead Costs
Hospital-based outpatient departments at major health systems like Penn Medicine and UPMC typically charge 40-60% more than independent surgical centers due to higher overhead costs. However, these academic medical centers may offer more complex procedures and better outcomes for complicated hernias, justifying the premium for some patients.
Insurance Market Competition in Pennsylvania
The presence of multiple major insurers including Highmark, Independence Blue Cross, and UnitedHealthcare creates competitive pressure that helps moderate negotiated rates with providers. This competitive landscape gives patients more network options and helps explain why Pennsylvania's costs remain below national averages despite having major metropolitan areas.
Physician Supply and Demand in Pennsylvania
With 914 active Hernia Repair providers serving 12.8 million residents, Pennsylvania maintains adequate specialist supply in urban areas while facing shortages in rural regions. This balanced supply-demand dynamic in major markets helps keep wait times reasonable and prevents the extreme pricing seen in physician shortage areas.
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.
Frequently Asked Questions — Hernia Repair Costs in Pennsylvania
What is the average cost of a Hernia Repair visit in Pennsylvania without insurance?
Does Pennsylvania Medicaid cover Hernia Repair visits?
How do I find an affordable Hernia Repair near me in Pennsylvania?
What is the difference in cost between an initial consultation and a follow-up visit?
Can I use an HSA or FSA to pay for a Hernia Repair visit in Pennsylvania?
How does telemedicine affect the cost of seeing a Hernia Repair in Pennsylvania?
Click a state to compare costs
Average Visit Cost
Office visit (CPT 49505)
Compare With Other States
| Rank | State | Average↓ |
|---|---|---|
| 1 | Wisconsin Range: $73 – $4,031 | $1,784 |
| 2 | Iowa Range: $457 – $2,449 | $1,346 |
| 3 | Alaska Range: $440 – $2,338 | $1,154 |
| 4 | Massachusetts Range: $397 – $2,168 | $1,133 |
| 5 | Montana Range: $378 – $2,328 | $1,120 |
| 6 | Georgia Range: $421 – $1,969 | $1,097 |
| 7 | South Dakota Range: $439 – $2,034 | $1,081 |
| 8 | Wyoming Range: $628 – $1,642 | $1,050 |
| 9 | New Hampshire Range: $504 – $1,521 | $1,002 |
| 10 | Nebraska Range: $637 – $1,214 | $994 |
| 11 | Washington Range: $592 – $1,594 | $984 |
| 12 | Minnesota Range: $344 – $1,787 | $970 |
| 13 | Rhode Island Range: $440 – $1,521 | $940 |
| 14 | North Dakota Range: $437 – $1,537 | $894 |
| 15 | Maine Range: $630 – $1,022 | $883 |
| 16 | Utah Range: $374 – $1,150 | $883 |
| 17 | California Range: $423 – $1,216 | $871 |
| 18 | Oregon Range: $440 – $1,399 | $866 |
| 19 | North Carolina Range: $426 – $1,453 | $859 |
| 20 | District of Columbia Range: $381 – $1,221 | $834 |
| 21 | Connecticut Range: $368 – $1,435 | $824 |
| 22 | New Mexico Range: $465 – $1,226 | $821 |
| 23 | West Virginia Range: $381 – $1,378 | $806 |
| 24 | Missouri Range: $493 – $1,027 | $804 |
| 25 | Colorado Range: $441 – $1,242 | $798 |
| 26 | Michigan Range: $440 – $1,216 | $797 |
| 27 | Delaware Range: $330 – $1,435 | $789 |
| 28 | Illinois Range: $90 – $1,569 | $789 |
| 29 | Pennsylvania Range: $333 – $1,448 | $781 |
| 30 | Idaho Range: $438 – $1,197 | $775 |
| 31 | Hawaii Range: $426 – $1,149 | $769 |
| 32 | New York Range: $364 – $1,435 | $768 |
| 33 | Kentucky Range: $396 – $1,220 | $763 |
| 34 | Vermont Range: $391 – $1,271 | $753 |
| 35 | Arkansas Range: $461 – $1,043 | $746 |
| 36 | New Jersey Range: $309 – $1,435 | $740 |
| 37 | Indiana Range: $90 – $1,448 | $722 |
| 38 | Mississippi Range: $409 – $1,251 | $718 |
| 39 | Tennessee Range: $440 – $1,016 | $705 |
| 40 | South Carolina Range: $391 – $1,170 | $705 |
| 41 | Texas Range: $407 – $1,086 | $699 |
| 42 | Alabama Range: $356 – $1,111 | $688 |
| 43 | Louisiana Range: $383 – $1,052 | $681 |
| 44 | Kansas Range: $493 – $872 | $667 |
| 45 | Virginia Range: $358 – $1,079 | $664 |
| 46 | Maryland Range: $381 – $1,079 | $653 |
| 47 | Oklahoma Range: $429 – $991 | $647 |
| 48 | Ohio Range: $328 – $1,039 | $638 |
| 49 | Nevada Range: $423 – $859 | $596 |
| 50 | Arizona Range: $432 – $882 | $585 |
| 51 | Florida Range: $35 – $920 | $337 |