The average cost in the United States for hernia repair surgery is $7,750 with prices typically ranging from $3,900 to over $12,500. The average cost for a patient who is un-insured is $7,900 while insured is $6,400. The largest cost factor to consider for hernia repair surgery is if you have the procedure performed in an in-patient facility like a hospital, or an outpatient facility such as a surgery center. Outpatient facilities are on average 42% cheaper. Based on our statistics and calculations, the target fair price for hernia repair surgery is $5,500 no matter if you are insured or un-insured.
Continue reading below to better understand how the price of hernia surgery is structured and how to find a fair price for your hernia repair surgery.
|New York, NY Hernia Repair Surgery Cost Average||$5,400 - $12,900|
|Los Angeles, CA Hernia Repair Surgery Cost Average||$6,600 - $15,700|
|Chicago, IL Hernia Repair Surgery Cost Average||$4,700 - $11,200|
|Miami, FL Hernia Repair Surgery Cost Average||$4,700 - $11,100|
|Dallas, TX Hernia Repair Surgery Cost Average||$4,400 - $10,500|
|Houston, TX Hernia Repair Surgery Cost Average||$4,700 - $11,000|
|Philadelphia, PA Hernia Repair Surgery Cost Average||$5,200 - $12,300|
|Phoenix, AZ Hernia Repair Surgery Cost Average||$5,300 - $12,500|
|Atlanta, GA Hernia Repair Surgery Cost Average||$4,700 - $11,100|
|Washington, DC Hernia Repair Surgery Cost Average||$5,200 - $12,400|
|Laparoscopic Hernia Repair Surgery - Groin or Abdomen Cost Average||$2,775 - $27,500|
|Open Hernia Repair Surgery - Groin or Abdomen Cost Average||$4,400 - $35,300|
|Brookings Ambulatory Surgery Center||Brookings , SD||$3,700 - $13,500|
|Wooster Ambulatory Surgery Center||Wooster , OH||$3,700 - $13,800|
|Surgery Center of Wilson||Wilson , NC||$3,700 - $13,600|
|SCA Nashville Surgery Center||Nashville , TN||$3,300 - $12,200|
|Decatur Healthcare||Decatur , IL||$3,600 - $13,200|
|Hamilton Ambulatory Surgery Center||Dalton , GA||$3,300 - $12,100|
|Greenwood Leflore Hospital||Greenwood , MS||$6,800 - $21,100|
|Lourdes Medical Pavilion, Surgicare Center||Paducah , KY||$3,300 - $12,400|
|Capitol City Surgery Center||Sacramento , CA||$5,100 - $19,000|
|South Alabama Outpatient Services||Enterprise , AL||$3,200 - $11,900|
|Court House Surgery Center||Cape May Court House , NJ||$4,300 - $15,800|
|Hendry Regional Medical Center||Clewiston , FL||$13,200 - $45,300|
|Physician Surgery Center||Rolla , MO||$3,400 - $12,600|
|William Newton Memorial Hospital||Winfield , KS||$11,000 - $35,300|
|Forest Canyon Endoscopy & Surgery Center||Flagstaff , AZ||$3,200 - $11,900|
|Good Samaritan Regional Health Center||Mount Vernon , IL||$7,700 - $24,100|
|River View Surgery Center||Marion , IN||$3,700 - $13,600|
|Port Arthur Day Surgery Center||Port Arthur , TX||$3,400 - $12,600|
|Stephens County Hospital||Toccoa , GA||$2,000 - $6,200|
|Middle Tennessee Surgical Care||Mc Minnville , TN||$3,300 - $12,200|
|SCDI Surgery Center||Carson City , NV||$4,000 - $14,700|
|New Ulm Medical Center||New Ulm , MN||$12,500 - $40,200|
|Burtonsville Surgical Center||Burtonsville , MD||$3,900 - $14,300|
|Northern Hospital of Surry County||Mount Airy , NC||$5,400 - $17,000|
|Northeast Regional Medical Center||Kirksville , MO||$9,700 - $30,500|
|Huntsville Surgery Center||Huntsville , TX||$3,400 - $12,600|
|Champlain Valley Physicians Hospital Medical Center||Plattsburgh , NY||$2,700 - $8,400|
|Island Hospital||Anacortes , WA||$4,700 - $14,600|
|Saint Vincent Mercy Hospital||Elwood , IN||$14,000 - $43,800|
|Panama City Surgery Center||Panama City , FL||$3,600 - $13,400|
In this article we are going to review the cost components of hernia repair surgery, explain why costs vary so much, and give you a better idea of a fair price for hernia repair surgery.
The total cost of hernia repair surgery includes a physician fee, facility fee, and anesthesia fee. While the percent makeup of each fee may vary, the percentage of our target fair price of $5,500 should be physician fee of $1,375, facility fee of $3,300, and anesthesia fee of $825.
The three main factors that will cause pricing to vary so greatly are:
Large price differences for Hernia Surgery call come down to negotiation. Learn more about medical procedure price negotiations.
The price of hernia surgery will vary greatly between in-patient and out-patient facilities. The national average of hernia surgery at in-patient facilities is $11,500 while that exact same procedure at out-patient facilities averaged $6,400.
Insured patients have historically paid less than un-insured patients for hernia repair surgery. The average hernia repair surgery cost for a patient who is un-insured is $7,900 while insured is $6,400.
In-network costs only relate to patients who have health insurance. In-network providers will almost always be cheaper than out-of-network providers. The national in-network price is $6,800 while an out-of-network price is $8,400.
There are two different types of hernia surgery that can be performed to fix a hernia. An open surgery, where the physician makes an incision allowing direct access to the hernia, and laparoscopic surgery where the surgeon accesses the hernia through tiny incisions, using an instrument with a camera attached and a video monitor to guide the repair. Open surgery usually cost less than laparoscopic surgery with an average price of $7,400 vs. $7,900 for laparoscopic.
Nearly everyone who has hernia repair surgery will have some payment responsibility. Un-insured patients will be responsible for the total cost of the surgery. Insured patients will be responsible for paying their deductible and then their co-insurance portion of the total procedure cost. As noted in our below example, assuming the deductible has been met and a 20% coinsurance, the patient, even though they have insurance, would still be responsible for $1,100. If the patient didn't shop and ended up at an in-patient facility and paying $11,500 their responsibility could jump up to $2,300. That's real money and a real example of why it's important to understand healthcare cost.
If the physician sees other areas which need to be repaired. With inguinal hernias - which can occur on both sides of the body - it's common for a surgeon to find a smaller hernia on the opposite side from the primary hernia. If this is fixed in the same procedure, you will be charged for the additional repair.
Typically the cost of hernia repair surgery mesh is included in the facility's fee. However, this should be confirmed in advance especially if you are an uninsured patient. Often mesh can cost 2-5 times more based on the brand or supplier used. Generally a fair price for mesh is $125-350.
In very rare cases, a physician may find tissues that must be tested in a lab. When this occurs, there will be a bill from the pathology lab.
A physician may prescribe painkillers and/or antibiotics post-surgery. In order to avoid outrageous prescription prices, make sure the prescriptions you receive are for medicines that are covered by your insurance policy or are the generic version of the name brand, to ensure you get the cheapest price of the medicine.
Patients often find better pricing by considering providers outside their hometown. In these cases, the savings on the procedure costs far outweigh the travel costs (flights, hotels, taxis, etc.)
In some cases you may be charged a separate fee for an initial consultation with the surgeon before the surgery. Typically 1-3 post-op visits within 90 days are included in the cost of your procedure.
In addition, there may need to be time taken off from work which may also influence the ultimate cost of the procedure. So, be sure to factor in the recovery times and your works sick leave policy to better understand what that risk/cost may be. The Family Medical Leave Act provides protection from job loss for medical leave but often employers are not responsible for paying beyond accrued vacation and sick leave.
While there are no alternative treatments for hernia repair surgery, you may be able to delay care at your doctor's discretion. If so, your doctor may prescribe you a hernia truss which is used to compress/push the bulging organ back into position. The cost of a hernia truss is not always covered by insurance but these costs are fairly negligible at $50 - $100 when compared to the cost of the surgery.
Review all of the costs for your procedure with your surgeon, not just their portion of the total cost.
Ask your surgeon to perform the procedure in an outpatient setting.
Check that all providers are in network. Often the anesthesiologist may be considered "out-of-network," which may cause their portion of the bill to be 2-3 times higher than if they were in-network. Unfortunately, this is becoming more and more common and it's critically important to ask so you can avoid an "out-of-network" bill.
Ask if there will be any other needs, services, and materials provided in the surgery that you'd be required to pay. An example is the mesh some surgeons use to repair the hernia.
Ask what the typical cost is if the surgeon finds other areas that need to be repaired during your procedure.
You may be able to save a significant amount of money on hernia repair surgery through our Patient Assist - Hernia Surgery Program which offers all-inclusive discounted pricing ranging from $2,500 - $5,500 and special financing options in select markets around the U.S. In addition, there may be financial assistance programs available to you if your financial situation presents a challenge for affording hernia repair surgery.
In the news