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Average Asking Price of a Hernia Surgery Tops $10,000 and Some Health Plans Won't Cover It

The average hospital's asking price of an inguinal or femoral hernia surgery is $10,600 for an adult male in the United States in 2006. (Source: Healthia)

For a patient with viable insurance, the majority of hernia surgery costs will be covered. Unfortunately, more than 40 million Americans don't have insurance. In addition, some health plans qualify some forms of hernia surgery as "elective."

A 1999 study in American Family Physician warned about the consequences of not covering hernia surgery because of cost concerns. "In the managed-care environment, elective herniorrhaphy is under increasing pressure. Some state health plans do not reimburse for elective hernia repairs. The long-term impact of complications secondary to untreated herniation is not fully known. A decrease in surgical repair may lead to an increase in hospitalizations related to incarceration or strangulation." (Source: T. Bax, B Sheppard, R. Crass. Surgical Options in the Management of Groin Hernias. American Family Physician. January 1999.)

Typically, hernias are in the news when athletes get them. In August of 2006, Colorado's Avalanche Hockey Club announced that defenseman Jordan Leopold needed to undergo hernia surgery, taking him out of the game for a number of months. After further medical testing and evaluation it was determined that rehabilitation alone would not correct the problem, Avalanche Head Trainer Matt Sokolowski told the press. We expect him to be back to full speed in 10-12 weeks.

In fact, the only real cure for a hernia is surgery, and sometimes once is not enough. Arkansas starting quarterback Robert Johnson, a fourth-year junior, underwent two hernia surgeries during two off-seasons in a row, according to the ARSN Sports Network.

Unfortunately, hernia symptoms aren't always obvious. In 2003, Oakland Raiders receiver Jerry Porter had to undergo a hernia surgery. Initially, the condition was diagnosed by doctors as a strained stomach muscle.

The signs of a hernia can range from a painless lump to a protrusion that cannot be pushed back into the abdomen. A lump in the groin or abdominal wall that increases in size while coughing is a possible sign of a hernia. A pain followed by tenderness and symptoms of bowel obstruction could be the sign of a strangulated hernia, an emergency that requires hernia surgery. Key symptoms to watch out for are tenderness and pain. While not every hernia is an immediate surgical emergency, any hernia can become one. So if you notice the symptoms, you should take a prompt trip to your doctor.

While hernias have often been associated with sports and weight lifting, they can actually turn up without heavy exercise. A hernia patient was likely born with an area of weakness in his or her abdominal wall. Pressure from strenuous exercise, obesity or even coughing can cause part of an internal organ to "bulge" through a wall in the body. Other conditions that can contribute to the formation or worsening of a hernia include chronic lung disease and fluid in the abdominal cavity. But having a history of hernias in the family is also a contributor.

In the event of "strangulation," when blood supply is cut off from the "bulge," the condition can become a life-or-death emergency that requires hernia surgery. Without insurance, a patient could be faced with a choice: risk serious medical complications or face a financial crisis. Some patients without insurance have actually held off on surgery, hoping to raise the money, only to discover that the hernia got worse with time and became more expensive to treat.

Luckily, hernia surgery is often an outpatient procedure, sometimes performed with local anesthesia. Patients aren't able to drive themselves home, but they typically don't have to spend the night at a hospital.

Unfortunately, hernias can appear suddenly. Even someone who believes he is too healthy for insurance can find himself suffering from a hernia. A costly surgery is the only cure.

Given the high price of a hernia surgery, it is essential for health consumers to select solid health plans that will cover non-emergency hernia repairs, and to never go without insurance. Independent sites that help consumers compare plans from different carriers, like Healthia inc, can help. Check the fine print in your policy. Affordable plans exist that will cover emergency and non-emergency cases. Health Savings Accounts can also be used with high-deductible plans to offset the financial burden of an operation.

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