Price Transparencybeta 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 · CDM 22126245 · SMITHVILLE, TX

22126245 — Zolgensma 4.6-5.0 Kg Kit

What each payer pays ASCENSION SETON SMITHVILLE (CCN 450143) 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.

$1,094,375 All-payer median here
$787,950 Cash / self-pay here
82 payer/plan-name variants
← This hospital National rates for 22126245 →
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
   
PROVIDER LIABLE $2,188,750 100.0% 1
HEALTH SOUTH LAB $2,188,750 100.0% 1
ORGAN SHARING ALLIANCE $2,188,750 100.0% 1
HOSPICE AUSTIN 20161001 $2,188,750 100.0% 1
CDM DEFAULT - NON-NEGOTIATED RATE $2,188,750 100.0% 1
ASCENSION PERSONALIZED CARE $2,188,750 100.0% 1
BCBS OON $2,188,750 100.0% 4
OXFORD HEALTH INSURANCE $2,079,312 90.0% 1
PPO NEXT (EBD,SHL) 20140101 $2,079,312 90.0% 1
Great-West Healthcare $2,079,312 90.0% 3
CAPP CARE Inc $2,024,594 85.0% 2
BeechStreet Corporation $1,969,875 80.0% 1
INTERPLAN $1,969,875 80.0% 1
Health Net $1,969,875 80.0% 3
Provider Network of America (PNOA) $1,969,875 80.0% 1
COASTAL COMP $1,969,875 80.0% 1
UHC STUDENT RESOURCE $1,969,875 80.0% 2
SHANNON HEALTH PLAN $1,969,875 80.0% 1
HEALTHSMART PPO $1,969,875 80.0% 2
Provider Partners Health Plan (PPHP) $1,947,988 78.0% 3
TRICARE $1,860,438 70.0% 3
ADDR CANCER TOGETHER $1,860,438 70.0% 3
Galaxy Health Network $1,860,438 70.0% 2
Cigna Healthcare $1,860,438 70.0% 11
INTEGRATED PPO $1,794,775 64.0% 2
First Health Network $1,783,831 63.0% 2
MultiPlan $1,751,000 60.0% 2
AVERDE HEALTH $1,751,000 60.0% 1
TRUE CHOICE $1,751,000 60.0% 1
PHCS (Private Healthcare Systems) $1,751,000 60.0% 4
EMPLOYERS HEALTH NETWORK (CHI,EBD,SHL,SMV,DCN) 20220301 $1,751,000 60.0% 1
FIRST CARE PPO $1,641,562 50.0% 3
FIRST CARE HMO $1,641,562 50.0% 3
COVENANT HEALTH $1,543,069 41.0% 4
COVENTRY HPN (EBD,SHL) 20140101 $1,532,125 40.0% 1
HEALTHSMART BENEFIT SOLUTIONS $1,532,125 40.0% 2
Humana $1,488,350 36.0% 12
EMPHESYS INSURANCE COMPANY $1,488,350 36.0% 1
BCBS HMO ESSENTIALS $1,367,969 25.0% 2
VISTA HEALTH $1,313,250 20.0% 2
Aetna $1,291,362 18.0% 29
CSHCN CIDC $1,280,419 17.0% 2
FIRST CARE PROVIDENCE $1,269,475 16.0% 1
SETON PERFORMANCE PLUS $1,258,531 15.0% 4
UnitedHealthcare $1,225,700 12.0% 31
Oscar Health $1,214,756 11.0% 2
WHOLE FOODS $1,170,981 7.0% 2
BCBS HPN $1,116,262 2.0% 3
HEART SAVER $1,094,400 0.0% 2
FIRST CARE PROVIDENCE EMPLOYEE $1,094,375 0.0% 2
Devoted Health $1,072,488 -2.0% 2
WellMed Medical Management (UHC subsidiary) $1,050,600 -4.0% 4
AUSTIN STATE HOSPITAL $984,938 -10.0% 1
BCBS BAV EXCHANGE $897,388 -18.0% 2
Superior HealthPlan $875,500 -20.0% 17
Sendero IdealCare $744,175 -32.0% 1
Medicare (Generic) $700,400 -36.0% 5
CORNERSTONE $656,625 -40.0% 1
TX REHAB $590,962 -46.0% 1
TEXAS REHAB $503,412 -54.0% 1
UTMB $503,412 -54.0% 1
WINGS $481,525 -56.0% 1
SMARTHEALTH $415,862 -62.0% 5
COUNTY INDIGENT $372,088 -66.0% 2
TRAVIS COUNTY INDIGENT $350,200 -68.0% 2
MDsave $306,425 -72.0% 1
BCBS of Texas $306,425 -72.0% 8
UnitedHealthcare Community Plan $273,594 -75.0% 4
DELL CHILDRENS HEALTH PLAN $273,594 -75.0% 8
Amerigroup $273,594 -75.0% 12
BCBS CHIP/CHIP PERINATE $273,594 -75.0% 6
WILLIAMSON/HAYS COUNTY INDIGNENT (SW) 20140101 $262,650 -76.0% 1
Texas Independence Health Plan $262,650 -76.0% 1
WELLPOINT STAR KIDS $251,706 -77.0% 2
WellCare Health Plans $240,762 -78.0% 1
CONNECTED SENIOR CARE $240,762 -78.0% 1
Allwell (Centene Medicare Advantage) $240,762 -78.0% 1
Ascension Health Alliance $240,762 -78.0% 1
WILLIAMSON/HAYS COUNTY INDIGNENT (NW) 20140101 $240,762 -78.0% 1
WELLPOINT CHIP/CHIP PERINATE $240,762 -78.0% 5
SENDERO CHAP $218,875 -80.0% 1
HEART SAVER VETERANS $75 -100.0% 1

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.