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 →

Export CSV
Payer

Gateway Health Plan

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.

$196 Overall median paid
108 hospitals
1,285,451 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 $4,865,400 $4,505,000 ↑ 8.0% 5 7
J1411 HCPCS Inj, Hemgenix, Per Tx Dose $3,943,235 $3,685,267 ↑ 7.0% 14 21
J1414 HCPCS Inj, Beqvez, Per Tx Dose $3,784,200 $3,508,750 ↑ 7.9% 5 9
J1413 HCPCS Inj Delandistrogene Mox Rokl $3,548,615 $3,325,455 ↑ 6.7% 11 17
J3394 HCPCS Inj, Lovotibeglogene Autotem $3,475,837 $3,248,446 ↑ 7.0% 12 19
J3393 HCPCS Inj, Betibeglogene Autotemce $3,151,942 $2,968,000 ↑ 6.2% 12 19
J3399 HCPCS Inj Onase Abepar-xioi Treat $2,592,750 $2,455,111 ↑ 5.6% 12 19
J3392 HCPCS Inj, Exagamglogene Autotem $2,495,240 $2,332,000 ↑ 7.0% 9 15
Q2057 HCPCS Afamitresgene Autoleucel $839,976 $813,967 ↑ 3.2% 15 27
Q2042 HCPCS Tisagenlecleucel Car-pos T $633,147 $621,313 ↑ 1.9% 25 46
Q2054 HCPCS Lisocabtagene Mara Car Pos T $618,421 $579,571 ↑ 6.7% 19 31
Q2056 HCPCS Ciltacabtagene Car-pos T $611,138 $599,737 ↑ 1.9% 21 35
Q2055 HCPCS Idecabtagene Vicleucel Car $610,161 $574,037 ↑ 6.3% 20 34
Q2041 HCPCS Axicabtagene Ciloleucel Car+ $585,411 $562,501 ↑ 4.1% 19 29
Q2053 HCPCS Brexucabtagene Car Pos T $538,395 $513,770 ↑ 4.8% 19 30
C1882 HCPCS — $40,604 $24,131 ↑ 68.3% 23 425
C1767 HCPCS — $34,865 $25,172 ↑ 38.5% 26 690
C1874 HCPCS — $7,175 $5,596 ↑ 28.2% 28 2,005
C1776 HCPCS — $4,008 $3,543 ↑ 13.1% 31 14,121
C1713 HCPCS — $1,679 $1,045 ↑ 60.7% 32 30,324

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
       
NC $1,092 $249 $4,301 6 72,549
VA $781 $207 $2,860 17 262,989
KY $750 $83 $5,333 6 57,425
IN $710 $45 $14,260 2 9,772
OH $261 $44 $1,982 10 67,198
WV $212 $53 $1,081 2 22,266
NJ $208 $99 $643 2 35,874
PA $196 $31 $1,424 61 757,165
MI $115 $48 $235 1 196
LA $105 $72 $136 1 17
DE — — — 0 0

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
       
Gateway Rehabilitation Hospital KY Florence $26,691 $21,396 $32,167 66 153
The Hospital of the University of Pennsylvania PA Philadelphia $15,845 $8,631 $27,180 1,316 1,316
PENNSYLVANIA HOSPITAL PA Philadelphia $15,530 $9,322 $26,624 2,092 2,092
PHYSICIANS' MEDICAL CENTER LLC IN New Albany $13,978 $3,497 $14,260 277 550
CONEMAUGH MINERS MEDICAL CENTER PA Hastings $11,967 $6,388 $21,146 2,198 2,207
Continuecare Hospital At Baptist Health Corbin KY Corbin $10,697 $1,899 $39,700 112 112
SHRINERS HOSPITALS FOR CHILDREN OH Dayton $6,140 $54 $16,621 2,276 2,278
Goshen Surgery Center — — $5,611 $2,834 $9,976 1,849 3,686
AHN EMERUS WESTMORELAND, LLC PA Greensburg $5,527 $218 $12,664 3,666 7,966
SHRINERS HOSPITALS FOR CHILDREN - PHILADELPHIA PA Philadelphia $5,429 $38 $15,989 2,311 2,399
NORTH CAROLINA BAPTIST HOSPITAL NC Winston-salem $2,317 $678 $6,465 148 21,510
CONEMAUGH MEYERSDALE MEDICAL CENTER PA Meyersdale $2,150 $212 $9,254 4,011 4,329
UNIVERSITY OF VIRGINIA MEDICAL CENTER VA Charlottesville $1,812 $617 $6,240 10,233 24,807
OHIO VALLEY SURGICAL HOSPITAL OH Springfield $1,808 $340 $3,489 1,654 1,684
UOFL HEALTH - SHELBYVILLE HOSPITAL KY Shelbyville $1,476 $156 $6,514 12,106 12,106
UOFL HEALTH - JEWISH HOSPITAL and Mary & Elizabeth Hospital KY Louisville $1,476 $156 $6,514 12,105 24,210
UNIVERSITY OF LOUISVILLE HOSPITAL KY Louisville $1,476 $156 $6,514 12,105 12,105
PHOENIXVILLE HOSPITAL PA Phoenixville $1,438 $57 $9,164 2,227 2,697
CARILION MEDICAL CENTER VA Roanoke $1,298 $394 $3,507 5,871 27,129
CARILION NEW RIVER VALLEY MEDICAL CENTER VA Christiansburg $1,226 $357 $3,424 4,952 22,656

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