Cost of a Hernia Repair Visit
in West Virginia
Reviewed by Momentary Medical Group West PC
West Virginia's rural healthcare infrastructure faces ongoing challenges with provider retention, particularly affecting surgical specialties like Hernia Repair across the state's mountainous regions. Patients seeking inguinal hernia repair in West Virginia typically pay between $381 and $1,378, with a median out-of-pocket cost of $657 based on negotiated insurance rates. West Virginia maintains 86 active Hernia Repair providers, giving patients options to browse providers throughout the state while comparing costs and coverage.
Average
$806
Median
$657
Lowest
$381
Highest
$1,378
Providers
86
4% below national average
Compare Similar Procedures
How does inguinal hernia repair compare to related procedures in West Virginia?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Knee Replacement Total knee replacement (arthroplasty) | 27447 | $1,204 | $1,729 | $4,734 | 88 |
| Hip Replacement Total hip replacement (arthroplasty) | 27130 | $90 | $1,677 | $4,590 | 99 |
| Cataract Surgery Cataract extraction with intraocular lens insertion | 66984 | $85 | $669 | $1,409 | 95 |
| Knee Arthroscopy Arthroscopy of the knee with meniscectomy | 29881 | $482 | $691 | $1,901 | 89 |
| Gallbladder Removal (Laparoscopic) Laparoscopic cholecystectomy | 47562 | $98 | $707 | $1,650 | 158 |
| Appendectomy (Laparoscopic) Laparoscopic appendectomy | 44970 | $85 | $754 | $1,557 | 110 |
| Hysterectomy (Laparoscopic) Laparoscopic total hysterectomy | 58571 | $85 | $1,094 | $2,122 | 98 |
| Septoplasty Nasal septum repair | 30520 | $461 | $780 | $1,698 | 88 |
| Tonsillectomy Tonsillectomy, primary or secondary | 42820 | $85 | $355 | $748 | 97 |
| Mastectomy Partial or simple mastectomy | 19301 | $366 | $777 | $1,695 | 94 |
| Carpal Tunnel Surgery Open carpal tunnel release | 64721 | $342 | $567 | $2,006 | 88 |
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 West Virginia
These hospitals in West Virginia are top-rated for patient satisfaction. Review data sourced from HCAHPS Patient Survey.
MADISON, WV
BECKLEY, WV
BERKELEY SPRINGS, WV
ROMNEY, WV
WELCH, WV
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 West Virginia
West Virginia's healthcare costs run approximately 2% below the national average, reflecting the state's lower cost of living and rural market dynamics. The Mountain State's challenging geography creates significant disparities in healthcare access and pricing between Charleston-Huntington metro areas and remote Appalachian communities.
Urban vs. Rural Provider Availability
Charleston, Morgantown, and Huntington concentrate most of West Virginia's surgical specialists, while rural counties often lack local hernia repair options. Patients in eastern panhandle counties may travel to Virginia or Maryland for care, while those in southern regions might seek treatment in Kentucky or Ohio. This geographic maldistribution creates higher travel costs for rural patients but potentially lower procedure costs in less competitive markets.
Facility Type and Overhead Costs
West Virginia University Medicine and Charleston Area Medical Center dominate the state's healthcare landscape, operating most hospital-based surgical practices with higher overhead costs. Independent surgical groups and ambulatory surgery centers offer alternatives in larger cities, typically with lower facility fees. Rural hospitals often rely on visiting surgeons or refer complex cases to regional medical centers, affecting both access and pricing patterns.
Insurance Market Competition in West Virginia
Highmark West Virginia maintains the largest market share, followed by UnitedHealthcare and Aetna, creating moderate competition that helps stabilize surgical care costs. The state's relatively small population limits insurer negotiating leverage compared to larger markets, but also reduces extreme pricing variations. Rural areas may have fewer in-network options, potentially limiting price competition for surgical services.
Physician Supply and Demand in West Virginia
With 86 active Hernia Repair providers serving approximately 1.8 million residents, West Virginia maintains adequate surgical capacity in urban areas but faces shortages in rural regions. The state's aging population and outmigration of younger residents affects both surgeon supply and demand patterns for hernia repair. Limited competition in some markets may contribute to stable but higher pricing, while areas with multiple providers often see more competitive rates.
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 West Virginia
What is the average cost of a Hernia Repair visit in West Virginia without insurance?
Does West Virginia Medicaid cover Hernia Repair visits?
How do I find an affordable Hernia Repair near me in West Virginia?
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 West Virginia?
How does telemedicine affect the cost of seeing a Hernia Repair in West Virginia?
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 |
