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Self-Pay Options and Health Insurance Information

Explore your payment options — whether you’re uninsured, have a high-deductible plan, or prefer to use your insurance:

Affordable Flat-Fee Surgery (No Insurance Needed)

​We offer transparent, all-inclusive pricing for patients without insurance or with high-deductible plans.

 

We Are Here to Help!

If you don’t have insurance — or if your deductible or co-insurance makes surgery unaffordable — we can help.

Patients who are uninsured, underinsured, or covered by high-deductible employer plans often face total costs between $15,000 to $20,000 at hospitals for a simple hernia repair — not including anesthesia or surgeon fees. For many, that’s simply not an option.

We believe cost should never prevent you from getting the care you need.

 

What Is “Self-Pay” or “Direct Pay” Surgery?

Also known as private-pay or direct-pay surgery, this model bypasses the complexities of insurance billing. Surprisingly, many of our patients save thousands by paying out of pocket.

We’ll even help you compare your insurance benefits to our transparent pricing so you can decide what’s best for you.

 

$4,000 All-Inclusive Flat Fee (Plus Mesh Cost)

For the most common hernias — inguinal and umbilical — we’ve negotiated deep discounts with our preferred surgical centers and anesthesia teams.

Your flat fee includes:

  • Surgeon fee

  • Anesthesia

  • Facility fee

  • All post-operative visits

The only additional cost is for mesh, if used. Mesh pricing is transparent, not marked up, and ranges from $58 to $800, depending on type and size.

 

Advanced Repairs, Tailored Pricing

For complex cases requiring laparoscopy, robotic surgery, or hospital-based care, we personally advocate on your behalf with facility leadership to secure the lowest possible self-pay price.

Our bundled cash-pay model is often the most affordable option for:

  • Patients without insurance

  • Medical tourists

  • Employees of self-funded employer plans

 

What's Not Included

Cash-pay prices do not include:

  • Pre-op labs or additional medical clearance

  • Prescription medications

  • Emergency care after discharge

Full payment is required prior to your procedure.

Using Your Health Insurance with AHS

We are out-of-network with all insurance plans.

Here’s what that means, and how we can still work with you.

Insurance Plan General Information

Every health insurance plan is different, and your financial obligations will vary based on your specific plan. You are responsible for your premium, along with any cost-sharing your plan requires. Co-pays, deductibles, and co-insurance payments are all agreed-upon, shared costs between you and your insurance company.

When you sign up for a health insurance plan, you should understand what your co-pay, co-insurance, and deductible will be from the beginning. Additionally, some medical services may not be covered by your plan. If you obtain services that are not covered by your plan, you will be financially responsible for those services.

 

Make sure to familiarize yourself with the benefits provisions, exclusions, and limitations of your plan before you seek any healthcare services whatsoever, so you don’t incur unnecessary or unexpected expenses.

 

What is Cost-Sharing?

 

"Cost-sharing" is a percentage of charges (for healthcare services provided) that you are responsible to pay, regardless of whether you go to an in-network or out-of-network provider.

For example, a plan with “80/20 Coverage” means the insurance company covers 80% of the charges, and you (the patient) pay 20% (your co-insurance). You pay this 20% after meeting your deductible, if applicable. To verify your plan’s cost-sharing rules, check your "Schedule of Benefits" or call the number on your insurance card. In many cases, we can help you obtain this information.

 

Out-of-Network Benefits

 

At AHS, our providers are out-of-network with all insurance plans.

If you would like to use your health insurance:

  • The anesthesiologist and surgical facility fees will typically be covered by your insurance.

  • You will pay AHS directly for surgery.

  • If you have out-of-network benefits, you may submit your AHS invoice to your insurance company for reimbursement.

 

Why We Don’t Participate In-Network

 

Insurance companies are lowering payments to physicians and raising deductibles for patients. This increases patient costs while maximizing insurer profits. In many cases, insurance companies do not negotiate with physicians at hospitals they list as "in-network."

For highly specialized providers like AHS, joining an insurance network is not viable. Our patient population is more focused and limited compared to large primary care practices. Participating in-network would require us to accept drastically reduced payments — which would compromise our ability to deliver the high-quality, personalized care we’re known for.

 

Authorization Services

 

Many insurance plans require prior approval for certain procedures. We will verify this information and, if needed, obtain that approval for you at an additional charge of $100.

 

Our cash-pay pricing structure remains a strong option for:

  • Uninsured patients

  • Those with high-deductible plans

  • Employees of self-funded employers

  • Out-of-town patients seeking bundled, affordable care

 

Our pricing model is based on actual costs and aligned with typical Medicare and commercial reimbursement rates.

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