Indiana · 49593

Initial Repair Of Sliding Hernia Of Abdomen, 3-10 Cm In Length in Indiana

Indiana Medicare Avg
$420.18
6% above national avg
National Medicare Avg
$394.75
All states combined
Billed Charge (IN)
$2,509.15
What providers submit
Est. Commercial (IN)
$1,115.32
National avg: $1,117.67
Est. Cash / Self-Pay (IN)
$1,088.35
Typical self-pay discount

Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.

469
Services in IN
210
Providers
N/A
Min Payment
N/A
Max Payment

Indiana Pricing in Context

In Indiana, CPT code 49593 (Initial Repair Of Sliding Hernia Of Abdomen, 3-10 Cm In Length) carries an average Medicare payment of $420.18 — 6% above the national benchmark of $394.75. 210 providers across the state submitted claims for this procedure in 2023, performing 469 total services. Individual payments in IN ranged from N/A at the low end to N/A at the high end, reflecting differences in provider setting (office vs. facility), modifiers, and the specific geographic locality code applied within the state.

The average billed charge in Indiana is $2,509.15, which is the figure uninsured patients would most likely encounter before any negotiation or charity discount. Medicare, by statute, only reimburses the allowed amount — the balance between billed and paid is written off under provider participation agreements. Insured patients generally pay a negotiated rate that falls between these two figures; the exact amount depends on plan design, deductible status, and in-network participation. Because Indiana sits above the national Medicare average, commercial rates in the state may also run higher than the US median.

Using RAND 2024 commercial-to-Medicare ratios for Digestive Surgery procedures, the estimated commercial insurance price in Indiana lands near $1,115.32, with self-pay cash prices typically around $1,088.35. Before scheduling, patients can request a Good Faith Estimate under the No Surprises Act, compare cash rates from hospital Machine-Readable Files, and confirm whether the provider is in-network with their specific plan. This page presents CMS reference data for informational use; it does not constitute medical or financial advice.

Frequently Asked Questions

How much does Initial Repair Of Sliding Hernia Of Abdomen, 3-10 Cm In Length cost in Indiana?

The average Medicare payment for Initial Repair Of Sliding Hernia Of Abdomen, 3-10 Cm In Length in Indiana is $420.18, which is 6% above the national average of $394.75. Providers in IN typically bill $2,509.15 for this procedure.

What does Initial Repair Of Sliding Hernia Of Abdomen, 3-10 Cm In Length cost with insurance in Indiana?

With commercial insurance in Indiana, Initial Repair Of Sliding Hernia Of Abdomen, 3-10 Cm In Length costs an estimated $1,115.32. Without insurance, the estimated cash price is $1,088.35. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.

How many providers perform Initial Repair Of Sliding Hernia Of Abdomen, 3-10 Cm In Length in Indiana?

210 providers in Indiana billed Medicare for Initial Repair Of Sliding Hernia Of Abdomen, 3-10 Cm In Length in 2023, performing 469 total services. Medicare payments ranged from N/A to N/A depending on the provider.

Is Initial Repair Of Sliding Hernia Of Abdomen, 3-10 Cm In Length cheaper in Indiana than the national average?

No — Initial Repair Of Sliding Hernia Of Abdomen, 3-10 Cm In Length costs 6% above the national average in Indiana. The state average Medicare payment is $420.18 compared to $394.75 nationally. Factors like local cost of living, provider competition, and regional Medicare fee schedules all influence state-level pricing.

Related

Data sourced from the CMS Medicare Physician and Other Practitioners dataset. See our methodology for details. Retrieved and formatted by PlainProcedure Editorial