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 →

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Payer

AmeriHealth Caritas

Negotiated rates filed under this payer name across every hospital in our index — the fee-schedule medians by code roll up across regional plans so one human payer is one row, not 47. Click any procedure or hospital row to drill into per-code detail.

$569 Overall median paid
443 hospitals
837,438 distinct codes
7,753,822 rate rows
→ search rates from this payer ← All payers

Top procedures

Procedures filed by this payer, sorted by what they pay. The vs national column is signed: green means below market, red means above.

Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Payer median National median vs national Hospitals Rates
       
J3391 HCPCS — $4,730,250 $4,505,000 ↑ 5.0% 8 8
J1414 HCPCS — $3,965,500 $3,710,000 ↑ 6.9% 8 9
J1411 HCPCS — $3,685,267 $3,710,000 ↓ 0.7% 23 25
J3394 HCPCS — $3,573,290 $3,286,000 ↑ 8.7% 14 15
J3393 HCPCS — $3,240,314 $3,006,423 ↑ 7.8% 14 15
J3392 HCPCS — $2,565,200 $2,448,600 ↑ 4.8% 13 14
J1413 HCPCS — $2,393,600 $3,325,455 ↓ 28.0% 26 33
J3399 HCPCS — $1,846,399 $2,469,189 ↓ 25.2% 29 39
Q2054 HCPCS — $868,759 $674,188 ↑ 28.9% 46 86
Q2055 HCPCS — $863,792 $625,184 ↑ 38.2% 46 86
Q2041 HCPCS — $708,750 $634,511 ↑ 11.7% 46 104
Q2042 HCPCS — $707,805 $754,974 ↓ 6.2% 48 118
Q2056 HCPCS — $683,162 $675,122 ↑ 1.2% 28 65
Q2053 HCPCS — $682,500 $620,080 ↑ 10.1% 46 104
18 MS_DRG — $350,159 $370,174 ↓ 5.4% 67 92
5834 APR_DRG — $241,583 $309,665 ↓ 22.0% 110 136
5884 APR_DRG — $229,025 $246,434 ↓ 7.1% 110 136
C1874 HCPCS — $3,550 $4,694 ↓ 24.4% 103 9,324
C1776 HCPCS — $2,215 $3,432 ↓ 35.4% 112 55,411
C1713 HCPCS — $421 $836 ↓ 49.7% 113 232,001

By state

Where this payer pays the most, by hospital state. IQR shows the middle 50% of rates within each state.

Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
State Median paid p25 p75 Hospitals Rate rows
       
IL $5,413 $4,143 $7,908 1 216
IA $3,224 $423 $8,025 2 17,032
GA $2,012 $64 $8,454 1 5,928
KY $1,722 $169 $3,978 1 34
AR $1,688 $1,688 $1,688 1 100
SC $1,423 $689 $3,098 4 120,880
WV $1,016 $274 $1,583 1 6
NC $781 $465 $1,061 73 2,381,400
DC $775 $207 $3,942 6 32,248
MD $717 $167 $2,670 10 1,310,923
NJ $569 $106 $3,730 15 239,849
TX $538 $151 $2,495 1 3,776
VT $518 $94 $2,643 2 12,178
DE $502 $110 $2,202 12 175,510
OH $410 $92 $2,724 85 432,253
PA $290 $42 $2,223 91 1,117,982
FL $264 $43 $2,322 71 1,197,756
MI $215 $38 $864 9 67,312
NH $159 $38 $496 14 402,283
IN $154 $28 $569 1 3,174
NY $150 $34 $643 2 6,289
VA $114 $26 $404 7 33,875
LA $88 $19 $402 33 192,818

Hospitals where this payer pays most

One row per hospital. Default sort is descending by overall median — click any header to flip.

Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Hospital State City Overall median p25 p75 Codes Rate rows
       
Encompass Health Rehabilitation Hospital Of Nittan PA Pleasant Gap $30,788 $24,485 $38,581 380 760
Encompass Health Rehab Hospital Of Middletown DE Middletown $29,585 $23,528 $37,073 380 760
Geisinger Encompass Health Rehabilitation Hospital PA Danville $28,930 $23,007 $36,252 380 380
Encompass Health Rehabilitation Hospital Of Readin PA Reading $28,512 $22,674 $35,728 380 380
Encompass Health Rehabilitation Hospital Of Mechan PA Mechanicsburg $27,913 $22,198 $34,977 380 380
John Heinz Institute of Rehabilitation PA Wilkes Barre Townshi $27,163 $59 $39,477 156 320
Allied Services Institute of Rehabilitation PA Scranton $26,926 $62 $39,450 156 161
Encompass Health Rehabilitation Hospital Of York, PA York $26,441 $21,028 $33,133 380 380
Kindred Hospitals-dayton OH Dayton $26,363 $12,722 $42,791 6 6
Encompass Health Rehabilitation Hospital Of Altoon PA Altoona $25,480 $20,263 $31,929 380 380
Children's National Medical Center DC Washington $24,189 $8,074 $50,422 1,891 1,891
Kindred Hospital Lima OH Lima $21,616 $21,616 $21,616 1 2
CHRISTIANA HOSPITAL DE Newark $20,137 $11,436 $40,431 459 534
Summa Rehab Hospital OH Akron $19,266 $12,584 $24,573 12 24
Shreveport Rehabilitation Hospital Llc LA Shreveport $16,193 $16,193 $16,193 1 1
SIBLEY MEMORIAL HOSPITAL DC Washington $12,962 $6,580 $19,995 197 197
Iberia Rehabilitation Hospital LA Lafayette $11,940 $9,382 $14,499 380 380
BAYHEALTH HOSPITAL, SUSSEX CAMPUS DE Milford $11,663 $2,971 $23,104 194 498
UNION HOSPITAL OF CECIL COUNTY MD Elkton $10,004 $5,532 $14,570 24 24
MERCY ST VINCENT MEDICAL CENTER OH Toledo $8,336 $5,417 $14,053 208 421

Source: payer name as filed in MRFs. UUIDs grouped by canonical name across 1 regional plan.