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Vermont

Cost of a Hernia Repair Visit
in Vermont

Reviewed by Momentary Medical Group West PC

Vermont's small but concentrated healthcare market, dominated by hospital systems in Burlington and scattered rural clinics, creates unique pricing dynamics for Hernia Repair services. Patients typically pay between $390 and $1,271 for hernia repair procedures, with a median cost of $595 based on negotiated insurance rates. With 325 active Hernia Repair providers across the state, Vermont patients can browse specialists from Chittenden County's medical centers to rural practices serving the Northeast Kingdom.

Average

$753

Median

$596

Lowest

$391

Highest

$1,271

Providers

325

National avg: $843Vermont: $753

11% below national average

Compare Similar Procedures

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

ProcedureCPTLowMedianHighProviders
Knee Replacement

Total knee replacement (arthroplasty)

27447$958$1,455$3,286326
Hip Replacement

Total hip replacement (arthroplasty)

27130$959$1,457$3,289329
Cataract Surgery

Cataract extraction with intraocular lens insertion

66984$403$643$1,548325
Knee Arthroscopy

Arthroscopy of the knee with meniscectomy

29881$410$629$1,326331
Gallbladder Removal (Laparoscopic)

Laparoscopic cholecystectomy

47562$492$746$1,597331
Appendectomy (Laparoscopic)

Laparoscopic appendectomy

44970$449$682$1,463337
Hysterectomy (Laparoscopic)

Laparoscopic total hysterectomy

58571$678$1,043$2,143325
Septoplasty

Nasal septum repair

30520$500$821$1,577327
Tonsillectomy

Tonsillectomy, primary or secondary

42820$220$342$693324
Mastectomy

Partial or simple mastectomy

19301$491$749$1,593324
Carpal Tunnel Surgery

Open carpal tunnel release

64721$338$519$1,053324

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.

Why Hernia Repair Visit Costs Vary Across Vermont

Vermont's healthcare costs run approximately 15% above national averages, reflecting the state's rural geography and limited provider competition. The concentration of specialists in Burlington and scattered rural practices creates access challenges that influence pricing across the Green Mountain State.

Urban vs. Rural Provider Availability

Burlington's Chittenden County hosts most of Vermont's surgical specialists, while rural counties often rely on traveling surgeons or require patients to travel significant distances. This geographic disparity doesn't necessarily create cost differences but affects appointment availability and travel expenses for patients.

Facility Type and Overhead Costs

The University of Vermont Medical Center dominates Burlington's market, with hospital-based outpatient surgery often carrying higher facility fees than independent surgical centers. Rural hospitals like those in Brattleboro and Rutland may offer competitive rates but have limited surgical volume compared to urban centers.

Insurance Market Competition in Vermont

BCBS Vermont and MVP Health Care control most of the commercial insurance market, creating moderate competition that keeps negotiated rates relatively stable. The limited number of major insurers means providers have less leverage in rate negotiations compared to larger, more diverse markets.

Physician Supply and Demand in Vermont

With 325 active Hernia Repair providers serving Vermont's small population, the state has adequate surgical capacity in urban areas but potential access issues in rural regions. This supply distribution creates modest wait times in Burlington but may require longer scheduling windows for patients in remote areas.

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 Vermont

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

Without insurance, hernia repair consultation and evaluation typically costs between $390 and $1,271 in Vermont, with a median cost around $595. These figures represent what insurers actually pay providers, so uninsured patients may face higher list prices but can often negotiate cash-pay discounts. Many Vermont surgical practices offer payment plans or sliding scale fees for uninsured residents.

Does Vermont Medicaid cover Hernia Repair visits?

Yes, Vermont's expanded Medicaid program covers hernia repair consultations and surgical procedures when medically necessary. Beneficiaries typically have minimal out-of-pocket costs for both evaluation and treatment. Vermont Medicaid works with most major hospitals and surgical practices throughout the state, though some specialists may have limited Medicaid appointment availability.

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

Compare costs across different facility types, as independent surgical centers often charge less than hospital-based practices. Ask about cash-pay discounts if you're uninsured, and consider community health centers that may offer surgical referrals at reduced rates. Rural practices sometimes offer competitive pricing compared to Burlington-area specialists, though travel costs should be factored into your decision.

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

Initial hernia evaluations typically fall within the $390-$1,271 range for comprehensive consultations, while follow-up visits usually cost significantly less, often in the $150-$300 range. The initial visit involves detailed examination, imaging review, and surgical planning, while follow-ups focus on healing progress and post-operative care. Most insurance plans cover both types of visits similarly.

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

Yes, both HSA and FSA funds can be used for hernia repair consultations and surgical procedures, as these qualify as eligible medical expenses. Keep all receipts and documentation for tax purposes. Many Vermont providers accept HSA/FSA debit cards directly, making payment convenient at the time of service.

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

While physical examination is essential for hernia diagnosis, some surgeons offer telehealth consultations for initial discussions or follow-up care at reduced rates, typically $100-$200. Vermont's rural geography makes telemedicine particularly valuable for post-operative follow-ups, reducing travel burden while maintaining quality care. However, in-person evaluation remains necessary for definitive diagnosis and surgical planning.

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