Cost of a Hernia Repair Visit
in Rhode Island
Reviewed by Momentary Medical Group West PC
Rhode Island's compact geography concentrates most healthcare services within the Providence metropolitan area, creating unique pricing dynamics for specialist visits. Hernia Repair patients in the Ocean State typically pay between $439.93 and $1,520.72, with a median out-of-pocket cost of $858.30 based on negotiated insurance rates. With 57 active providers across the state, Rhode Island offers good access to Hernia Repair services for patients throughout the region.
Average
$940
Median
$858
Lowest
$440
Highest
$1,521
Providers
57
12% above national average
Compare Similar Procedures
How does inguinal hernia repair compare to related procedures in Rhode Island?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Knee Replacement Total knee replacement (arthroplasty) | 27447 | $1,136 | $2,323 | $6,051 | 57 |
| Hip Replacement Total hip replacement (arthroplasty) | 27130 | $80 | $1,978 | $6,060 | 74 |
| Cataract Surgery Cataract extraction with intraocular lens insertion | 66984 | $448 | $960 | $2,135 | 58 |
| Knee Arthroscopy Arthroscopy of the knee with meniscectomy | 29881 | $452 | $895 | $2,410 | 58 |
| Gallbladder Removal (Laparoscopic) Laparoscopic cholecystectomy | 47562 | $91 | $1,006 | $1,921 | 66 |
| Appendectomy (Laparoscopic) Laparoscopic appendectomy | 44970 | $80 | $884 | $1,752 | 79 |
| Hysterectomy (Laparoscopic) Laparoscopic total hysterectomy | 58571 | $85 | $1,277 | $3,201 | 60 |
| Septoplasty Nasal septum repair | 30520 | $555 | $1,052 | $2,160 | 56 |
| Tonsillectomy Tonsillectomy, primary or secondary | 42820 | $239 | $441 | $742 | 58 |
| Mastectomy Partial or simple mastectomy | 19301 | $509 | $1,087 | $2,642 | 61 |
| Carpal Tunnel Surgery Open carpal tunnel release | 64721 | $364 | $877 | $1,957 | 58 |
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.
Why Hernia Repair Visit Costs Vary Across Rhode Island
Rhode Island's healthcare costs run approximately 13% above national averages, reflecting the state's concentrated population and limited geographic area that reduces competitive pressure. The Ocean State's small size creates unique market dynamics where a handful of health systems control most specialist services.
Urban vs. Rural Provider Availability
Nearly all Hernia Repair specialists concentrate in the Providence-Warwick metropolitan area, with limited options in South County and Newport regions. This urban concentration can mean longer travel times for rural patients but generally provides more competitive pricing within the metro area.
Facility Type and Overhead Costs
Rhode Island Hospital, The Miriam Hospital, and Kent Hospital dominate the surgical landscape, with their hospital-based outpatient centers typically charging higher facility fees than independent surgery centers. Lifespan and Care New England health systems control most specialist practices, influencing regional pricing structures.
Insurance Market Competition in Rhode Island
With Blue Cross Blue Shield of Rhode Island holding significant market share alongside UnitedHealthCare and Tufts Health Plan, the insurance landscape offers moderate competition. This concentrated market allows insurers to negotiate competitive rates but may limit patient choice compared to larger states.
Physician Supply and Demand in Rhode Island
The state's 57 active Hernia Repair providers serve a population of just over one million, indicating adequate specialist availability relative to demand. This reasonable supply helps moderate pricing compared to underserved areas, though wait times can still vary by specific surgeon and facility.
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 Rhode Island
What is the average cost of a Hernia Repair visit in Rhode Island without insurance?
Does Rhode Island Medicaid cover Hernia Repair visits?
How do I find an affordable Hernia Repair near me in Rhode Island?
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 Rhode Island?
How does telemedicine affect the cost of seeing a Hernia Repair in Rhode Island?
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 |