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 7092831 · LULING, TX

7092831 — Tibial Revision Mbt Sz 2 25

What each payer pays ASCENSION SETON EDGAR B DAVIS (CCN 451371) 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.

$49,448 All-payer median here
$38,698 Cash / self-pay here
87 payer/plan-name variants
← This hospital National rates for 7092831 →
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
   
CDM DEFAULT - NON-NEGOTIATED RATE $107,496 117.4% 1
HEALTH SOUTH LAB $107,496 117.4% 1
PROVIDER LIABLE $107,496 117.4% 1
BCBS OON $107,496 117.4% 4
ASCENSION PERSONALIZED CARE $107,496 117.4% 1
ORGAN SHARING ALLIANCE $107,496 117.4% 1
Health Net $102,121 106.5% 1
PPO NEXT (EBD,SHL) 20140101 $102,121 106.5% 1
OXFORD HEALTH INSURANCE $102,121 106.5% 1
CAPP CARE Inc $99,434 101.1% 2
SHANNON HEALTH PLAN $96,746 95.7% 1
USA HEALTHNET $96,746 95.7% 1
HEALTHSMART PPO $96,746 95.7% 1
BeechStreet Corporation $96,746 95.7% 1
GALAXY HC PPO $96,746 95.7% 1
PNOA PPO $96,746 95.7% 1
INTERPLAN $96,746 95.7% 1
COASTAL COMP $96,746 95.7% 1
UHC STUDENT RESOURCE $96,746 95.7% 2
PPHP MCR ADVANTAGE $95,671 93.5% 3
INTEGRATED PPO $95,671 93.5% 1
Great-West Healthcare $94,059 90.2% 2
Cigna Healthcare $91,371 84.8% 10
TRICARE $91,371 84.8% 2
ADDR CANCER TOGETHER $91,371 84.8% 3
MEDICARE OON $91,371 84.8% 3
WellMed Medical Management (UHC subsidiary) $91,371 84.8% 3
COVENANT HEALTH $88,147 78.3% 3
AVERDE HEALTH $85,997 73.9% 1
TX TRUE CHOICE $85,997 73.9% 1
PHCS (Private Healthcare Systems) $85,997 73.9% 3
MultiPlan $85,997 73.9% 1
EMPLOYERS HEALTH NETWORK (CHI,EBD,SHL,SMV,DCN) 20220301 $85,997 73.9% 1
First Health Network $83,847 69.6% 1
FIRST CARE PPO $80,622 63.0% 2
FIRST CARE HMO $80,622 63.0% 2
HEALTHSMART BENEFIT SOLUTIONS $75,247 52.2% 2
COVENTRY HPN (EBD,SHL) 20140101 $75,247 52.2% 1
Oscar Health $74,172 50.0% 3
EMPHESYS $73,097 47.8% 1
Humana $73,097 47.8% 9
BCBS HMO ESSENTIALS $67,185 35.9% 2
VISTA HEALTH $64,497 30.4% 2
CSHCN CIDC $62,885 27.2% 2
FIRST CARE PROVIDENCE $62,348 26.1% 1
SETON PERFORMANCE PLUS $61,810 25.0% 4
HUMANA HMO CUST $61,810 25.0% 2
WHOLE FOODS $57,510 16.3% 2
DEVOTED HEALTH MCR REPLACEMENT $56,973 15.2% 2
Aetna $55,898 13.0% 24
BCBS HPN $54,823 10.9% 3
HEART SAVER $53,772 8.7% 2
FIRST CARE PROVIDENCE EMPLOYEE $53,748 8.7% 2
UnitedHealthcare $49,448 0.0% 26
AUSTIN STATE HOSPITAL $48,373 -2.2% 1
SUPERIOR CHIP/CHIP PERINATE $48,373 -2.2% 2
BCBS BAV EXCHANGE $44,073 -10.9% 2
Superior HealthPlan $42,998 -13.0% 15
SUPERIOR STAR $42,998 -13.0% 4
SENDERO IDEALCARE $34,399 -30.4% 2
CORNERSTONE $32,249 -34.8% 1
TX REHAB $29,024 -41.3% 1
SMARTHEALTH $24,724 -50.0% 5
UTMB $24,724 -50.0% 1
TEXAS REHAB $24,724 -50.0% 1
WINGS $23,649 -52.2% 1
MDSAVE $22,574 -54.3% 1
WellCare Health Plans $20,424 -58.7% 1
Allwell (Centene Medicare Advantage) $20,424 -58.7% 1
COUNTY INDIGENT $19,349 -60.9% 3
BCBS of Texas $19,349 -60.9% 6
TRAVIS COUNTY INDIGENT $18,274 -63.0% 2
SENDERO CHAP $18,274 -63.0% 1
UHC MCR REPLACEMENT $18,274 -63.0% 1
CONNECTED SENIOR CARE $18,274 -63.0% 1
DELL CHILDRENS HEALTH PLAN $15,049 -69.6% 4
WELLPOINT STAR PLUS $15,049 -69.6% 6
BCBS CHIP/CHIP PERINATE $15,049 -69.6% 6
UHC STAR KIDS $15,049 -69.6% 4
DELL STAR $15,049 -69.6% 4
WELLPOINT STAR $15,049 -69.6% 6
WELLPOINT STAR KIDS $14,512 -70.7% 2
BCBS STAR KIDS $14,512 -70.7% 2
WELLPOINT CHIP/CHIP PERINATE $14,512 -70.7% 4
WILLIAMSON/HAYS COUNTY INDIGNENT (SW) 20140101 $12,899 -73.9% 1
WILLIAMSON/HAYS COUNTY INDIGNENT (NW) 20140101 $11,825 -76.1% 1
HEART SAVER VETERANS $75 -99.8% 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.