004983LWJH (CDM) — raw rate rows

CDM · raw rates

004983LWJH — Hc Medtronic Generator 3023

Per-row negotiated rates, exactly as filed by each hospital. Aggregated views below summarize across hospitals; the bottom table shows the underlying rows.

View state-by-state → View hospital-by-hospital →

Typical negotiated price $10,565

Usually $8,950–$21,735 (25th–75th percentile) across 1 hospital · 11 payers.

“Negotiated” is the hospital’s negotiated facility rate for this CDM 004983LWJH — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.

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This estimate runs on the hospital’s facility charge only. The surgeon’s and anesthesiologist’s fees are billed separately and aren’t in this number — your EOB shows your complete total.

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Out-of-pocket max (assumed — typical plan) Coinsurance % (after deductible)

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Per-month price trends are temporarily unavailable while we rebuild them on quality-filtered rates. The medians, percentiles, and per-hospital rates on this page are the quality-filtered figures.

Hospital rates (per row)

Showing consumer-grade rates only. Flagged / outlier filings (excluded from the medians above) are hidden — tick “Show flagged / outlier rates” to include them.

Hospital	Payer	Plan	Negotiated rate	Gross	Cash	Observed	Source
JEFFERSON HEALTHCARE Outpatient	CHPW MCAID	CHPW MCAID	$7,988.28	$25,570.67	$20,456.54	2026-05-04	MRF ↗
JEFFERSON HEALTHCARE Outpatient	MOLINA MCAID	MOLINA MCAID	$8,162.16	$25,570.67	$20,456.54	2026-05-04	MRF ↗
JEFFERSON HEALTHCARE Outpatient	AMERIGROUP MCAID-ALL PLANS	AMERIGROUP MCAID-ALL PLANS	$8,399.97	$25,570.67	$20,456.54	2026-05-04	MRF ↗
JEFFERSON HEALTHCARE Outpatient	COORD CARE MCAID IP/OP ONLY	COORD CARE MCAID IP/OP ONLY	$8,558.50	$25,570.67	$20,456.54	2026-05-04	MRF ↗
JEFFERSON HEALTHCARE Outpatient	AETNA MCR ADV	AETNA MCR ADV	$8,949.73	$25,570.67	$20,456.54	2026-05-04	MRF ↗
JEFFERSON HEALTHCARE Outpatient	HEALTHNET TRICARE-ALL PLANS	HEALTHNET TRICARE-ALL PLANS	$8,949.73	$25,570.67	$20,456.54	2026-05-04	MRF ↗
JEFFERSON HEALTHCARE Outpatient	MOLINA MCR ADV	MOLINA MCR ADV	$8,949.73	$25,570.67	$20,456.54	2026-05-04	MRF ↗
JEFFERSON HEALTHCARE Outpatient	REGENCE MEDICARE	REGENCE MEDICARE	$9,128.73	$25,570.67	$20,456.54	2026-05-04	MRF ↗
JEFFERSON HEALTHCARE Outpatient	CHPW MCR ADV	CHPW MCR ADV	$9,941.88	$25,570.67	$20,456.54	2026-05-04	MRF ↗
JEFFERSON HEALTHCARE Outpatient	MOLINA MARKETPLACE-ALL OTHER PLANS	MOLINA MARKETPLACE-ALL OTHER PLANS	$11,187.17	$25,570.67	$20,456.54	2026-05-04	MRF ↗
JEFFERSON HEALTHCARE Outpatient	UHC COMM/MARKETPLACE-ALL PLANS	UHC COMM/MARKETPLACE-ALL PLANS	$14,319.58	$25,570.67	$20,456.54	2026-05-04	MRF ↗
JEFFERSON HEALTHCARE Outpatient	REGENCE-ALL OTHER PLANS	REGENCE-ALL OTHER PLANS	$19,178.00	$25,570.67	$20,456.54	2026-05-04	MRF ↗
JEFFERSON HEALTHCARE Outpatient	PREMERA-ALL PLANS	PREMERA-ALL PLANS	$21,735.07	$25,570.67	$20,456.54	2026-05-04	MRF ↗
JEFFERSON HEALTHCARE Outpatient	CHPW COMMERCIAL-ALL OTHER PLANS	CHPW COMMERCIAL-ALL OTHER PLANS	$21,735.07	$25,570.67	$20,456.54	2026-05-04	MRF ↗
JEFFERSON HEALTHCARE Outpatient	COORD CARE CASCADE IP/OP ONLY	COORD CARE CASCADE IP/OP ONLY	$23,013.60	$25,570.67	$20,456.54	2026-05-04	MRF ↗
JEFFERSON HEALTHCARE Outpatient	AETNA-ALL OTHER PLANS	AETNA-ALL OTHER PLANS	$23,013.60	$25,570.67	$20,456.54	2026-05-04	MRF ↗
JEFFERSON HEALTHCARE Outpatient	COORD CARE COMM/EXCHGE-ALL OTHER PLANS	COORD CARE COMM/EXCHGE-ALL OTHER PLANS	$23,013.60	$25,570.67	$20,456.54	2026-05-04	MRF ↗
JEFFERSON HEALTHCARE Outpatient	CIGNA-ALL PLANS	CIGNA-ALL PLANS	$23,013.60	$25,570.67	$20,456.54	2026-05-04	MRF ↗