Price Transparency Hospital negotiated rates

Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

Payer comparison · HCPCS J9316 · MOREHEAD, KY

J9316 — Pertuzu, Trastuzu, 10 Mg

What each payer pays ST CLAIRE REGIONAL MEDICAL CENTER (CCN 180018) for this procedure, and where each sits versus the all-payer median at this facility. Find your plan to see whether you're above or below the market here.

$33,845 All-payer median here
$52,856 Cash / self-pay here
10 payer/plan-name variants
← This hospital National rates for J9316 →
Per-payer negotiated rate at this facility. Use the column headers to sort, the filter row to narrow results.
Payer / plan Median negotiated vs all-payer median Rate rows
   
KY HEALTH CO-OP - ALL PLANS $76,346 125.6% 2
Carelon Behavioral Health $61,664 82.2% 2
Aetna $58,728 73.5% 2
HEALTHLINK PPO $40,710 20.3% 2
Anthem (Elevance Health) $33,845 0.0% 13
Humana $32,887 -2.8% 3
WellCare Health Plans $28,071 -17.1% 4
COVENTRY MEDICAID-ALL PLANS $16,491 -51.3% 2
PASSPORT HEALTH PLAN $14,183 -58.1% 2
CareSource $71 -99.8% 2

Median over current-blob negotiated rates (COALESCE of standard / median / min–max midpoint, $0.01–$5M sentinel guard). Payers are canonical-grouped where a mapping exists; unmapped regional-plan name variants may appear as separate rows.