All insurances cover hernia consultations as well as hernia surgery if needed. Hernia treatment is never considered ‘cosmetic’ or ‘elective’. We have never had an insurance carrier deny a consultation with our center. Here we discuss insurance and costs for hernia surgery.
We work with many patients who have either lost their insurance, or just don’t have insurance right now. At California Hernia Specialists we feel every patient should have the ability to obtain hernia surgery or hernia repair regardless of their financial status. Our office provides clear, up front, cash pricing for hernia patients (see below) without any hidden costs.
Uninsured and High Deductible Patients: How Much Does Hernia Surgery Cost?
We work closely with patients who currently do not have insurance, or have a very high deductible and are essentially looking for cash options. In today’s job climate and with escalating insurance premiums, this is not an uncommon situation! For cash patients, our office is happy to schedule you for a consultation with Dr. Harris without any further obligation. For patients with high deductibles, if you would like to be treated as a cash patient, please let our office know up front.
If you decide to have surgery, the costs for patients without insurance are $2000 for the surgeon fees, and $2000 for the surgery center fees (including the operating room time, all materials including mesh, and recovery), and $550 for the Anesthesiologists fee for a total of cost $4550.
We don’t have any other hidden fees or other ‘follow-up’ visit charges. The only other charges that you may incur would be for pre-operative blood-work, an EKG (if needed), and for your post-operative pain medication (if prescribed). Even these costs are usually very reasonable at a number of locations around our office or your home, whichever is more convenient.
Please keep in mind that our pricing covers open hernia repairs which are often the most cost effective. Laparoscopic hernia repairs require higher charges due to the costs of the equipment involved. Similarly, more than one hernia is more expensive, and usually costs an addition 50%.Below is a short video in which Dr. Harris discusses the costs associated with hernia repair for patients without insurance.
Hernia Surgery CostsDr. Todd Harris explains the 3 separate fees that go into the final cost for hernia surgery, and how much hernia surgery costs at California Hernia Specialists.
Insurance and CostsWe know medical billing and insurance can be confusing. Rest assured, our office staff as a courtesy will verify your eligibility for your consultation and help you understand what costs, if any, may be required. If you decide to have surgery our office staff can help provide support in understanding and obtaining your insurance benefits required for surgery.
What Insurance Do You Accept?At California Hernia Specialists we accept most insurances including all PPO insurances, Medicare, as well as a number of IPA’s or managed care patients. We rarely have a patient that is not able to be seen at our center due to insurance. As a courtesy we can verify eligibility for your consultation by calling our friendly office staff. If you prefer, you can include your insurance information on our ‘Contact Us’ form and our office will ensure you are covered for your consultation.
Most insurance companies allow patients to self refer themselves for a hernia evaluation. If your insurance requires a referral or an authorization, our office is happy to help obtain that for you.
Surgery CoverageOur office staff has extensive experience in obtaining full authorization for surgical procedures. Our knowledgeable staff can provide quotes for multiple ambulatory surgery center(s), identify your expected out-of-pocket costs for both Dr. Harris and the surgical facility, identify what portions of your deductible have been met, and what portions are still not met. Often patients will have only minimal out of pocket expenses.
Forms of PaymentOur office accepts most forms of payment. For any co-pays, cash, credit cards and ApplePay are accepted. For patients who must pay for a portion of the surgery out of pocket, those fees will need to be paid before the surgery. Patients without insurance and cash patients can work with our office to arrange payments before the procedure.
In-Network and Out-of-Network
Our office is in-network for almost all major insurances as described above. In addition, we work with several surgery centers which are in-network and out-of-network for various different insurances. This essentially guarantees that you will have an in-network and out-of-network option for your surgery center. Our goal at California Hernia Specialists is to provide you specialty care within the constraints of your insurance while providing you with the most cost effective options.
Dr. Harris sees patients from all over Southern California, the greater US, and Canada. Our Newport Beach office is conveniently located in Central Orange County adjacent to John Wayne Airport between the 405, 73, and 55 highways. Our office staff are experienced in verifying insurance coverage for each patient’s consultation, as well as offering excellent pricing for patients without insurance (see costs above).