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 →

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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.

$717 Overall median paid
487 hospitals
9,335,639 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 Inj, Atidarsagene Autotemcel $4,377,500 $4,505,000 ↓ 2.8% 10 10
J3394 HCPCS Inj, Lovotibeglogene Autotem $3,573,290 $3,286,000 ↑ 8.7% 19 22
J3393 HCPCS Inj, Betibeglogene Autotemce $3,240,314 $2,994,107 ↑ 8.2% 18 21
J1411 HCPCS Inj, Hemgenix, Per Tx Dose $2,839,152 $3,703,693 ↓ 23.3% 27 31
J3392 HCPCS Inj, Exagamglogene Autotem $2,565,200 $2,401,960 ↑ 6.8% 19 22
J1413 HCPCS Inj Delandistrogene Mox Rokl $2,325,600 $3,324,572 ↓ 30.0% 29 36
J3399 HCPCS Inj Onase Abepar-xioi Treat $1,638,202 $2,466,282 ↓ 33.6% 33 43
Q2053 HCPCS Brexucabtagene Car Pos T $660,000 $591,650 ↑ 11.6% 54 115
Q2041 HCPCS Axicabtagene Ciloleucel Car+ $660,000 $608,101 ↑ 8.5% 53 113
Q2042 HCPCS Tisagenlecleucel Car-pos T $639,810 $738,272 ↓ 13.3% 53 130
Q2055 HCPCS Idecabtagene Vicleucel Car $622,245 $622,245 0% 51 95
Q2054 HCPCS Lisocabtagene Mara Car Pos T $618,792 $640,950 ↓ 3.5% 52 96
Q2056 HCPCS Ciltacabtagene Car-pos T $599,558 $646,415 ↓ 7.2% 36 76
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies $330,299 $359,358 ↓ 8.1% 118 210
5834 APR_DRG — $247,831 $307,273 ↓ 19.3% 131 180
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc $225,254 $249,124 ↓ 9.6% 131 206
5831 APR_DRG — $171,841 $146,591 ↑ 17.2% 137 225
C1874 HCPCS — $3,532 $4,814 ↓ 26.6% 139 11,551
C1776 HCPCS — $2,237 $3,390 ↓ 34.0% 147 75,953
C1713 HCPCS — $477 $862 ↓ 44.7% 156 299,833

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
       
AR $1,688 $1,688 $1,688 1 200
DC $1,591 $285 $18,610 8 12,716
DE $594 $126 $2,388 13 149,998
FL $330 $55 $2,772 75 1,564,889
GA $2,016 $64 $8,455 1 5,925
IA $97 $30 $374 3 25,939
IL $5,458 $4,198 $7,898 1 206
IN $127 $23 $434 1 2,937
KY $2,308 $2,308 $2,308 3 897
LA $111 $25 $468 41 221,440
MA $817 $817 $841 1 6,376
MD $717 $167 $2,670 9 1,310,873
MI $673 $104 $2,024 13 76,046
NC $810 $629 $1,073 77 4,061,932
NH $183 $35 $669 16 228,160
NJ $654 $115 $3,765 15 226,044
NY $127 $31 $478 1 6,086
OH $404 $89 $2,592 105 428,787
OK $681 $136 $2,639 1 46
PA $370 $51 $2,829 85 917,590
SC $905 $134 $4,489 4 52,545
SD $1,524 $283 $2,675 1 3,340
TN $630 $630 $630 1 3
TX $538 $151 $2,495 1 3,776
VA $162 $26 $1,932 7 16,169
VT $473 $87 $2,508 1 11,880
WV $1,902 $1,902 $1,902 2 839

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 $38,581 380 380
Encompass Health Rehab Hospital Of Middletown DE Middletown $29,585 $23,528 $37,073 380 380
MEDSTAR WASHINGTON HOSPITAL CENTER DC Washington $28,266 $15,903 $49,282 1,320 1,320
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 $39,477 156 160
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 1
CHRISTIANA HOSPITAL DE Newark $20,137 $11,436 $40,431 459 534
Summa Rehab Hospital OH Akron $19,266 $12,584 $24,573 12 12
JACKSON HEALTH SYSTEM FL Miami $16,878 $11,021 $26,321 649 649
Shreveport Rehabilitation Hospital Llc LA Shreveport $16,193 $16,193 $16,193 1 1
ST CHRISTOPHER'S HOSPITAL FOR CHILDREN PA Philadelphia $13,509 $1,494 $29,992 1,179 1,368
EXCELA HEALTH - FRICK HOSPITAL PA Mount Pleasant $12,608 $7,575 $21,430 2,122 2,122
Iberia Rehabilitation Hospital LA Lafayette $11,940 $9,382 $14,499 380 380
SHRINERS HOSPITALS FOR CHILDREN SC Greenville $11,048 $5,021 $21,045 1,449 1,751
SIBLEY MEMORIAL HOSPITAL DC Washington $10,790 $2,969 $17,401 219 219

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