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

GOLDEN RULE INSURANCE

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.

$1,253 Overall median paid
119 hospitals
2,055,814 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
       
J3399 HCPCS Inj Onase Abepar-xioi Treat $2,268,389 $2,455,111 ↓ 7.6% 4 6
Q2055 HCPCS Idecabtagene Vicleucel Car $1,618,964 $574,037 ↑ 182.0% 3 6
Q2054 HCPCS Lisocabtagene Mara Car Pos T $1,584,300 $579,571 ↑ 173.4% 3 6
Q2041 HCPCS Axicabtagene Ciloleucel Car+ $1,501,368 $562,501 ↑ 166.9% 3 6
Q2053 HCPCS Brexucabtagene Car Pos T $1,486,905 $513,770 ↑ 189.4% 3 6
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies $1,119,385 $168,055 ↑ 566.1% 14 25
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc $282,281 $186,516 ↑ 51.3% 17 28
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures $281,878 $74,509 ↑ 278.3% 11 22
215 MS_DRG Other Heart Assist System Implant $258,105 $73,023 ↑ 253.5% 20 32
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheterization With Mcc $250,176 $69,822 ↑ 258.3% 20 32
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Neck With Major O.r. Procedures $235,791 $145,435 ↑ 62.1% 19 31
231 MS_DRG Coronary Bypass With Ptca With Mcc $218,520 $60,505 ↑ 261.2% 18 30
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Or Infection With Mcc $217,833 $59,651 ↑ 265.2% 17 29
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Neck Without Major O.r. Procedures $209,478 $97,418 ↑ 115.0% 20 32
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheterization With Mcc $199,037 $55,923 ↑ 255.9% 22 34
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc $198,179 $55,935 ↑ 254.3% 21 33
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheterization With Cc $170,445 $47,458 ↑ 259.1% 21 33
C1776 HCPCS — $3,233 $3,543 ↓ 8.7% 27 4,374
C1889 HCPCS — $2,845 $1,642 ↑ 73.2% 30 3,468
C1713 HCPCS — $940 $1,045 ↓ 10.1% 30 16,794

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
       
PA $6,102 $1,493 $11,093 2 4,379
AR $4,933 $1,481 $17,312 3 2,267
MO $2,635 $89 $2,839 1 2,517
NJ $2,135 $157 $7,998 6 122,081
ID $1,369 $571 $2,759 1 76,136
UT $1,253 $538 $2,665 16 1,226,499
NC $1,121 $351 $3,492 6 154,435
MT $1,062 $264 $4,294 1 1,880
OH $879 $293 $3,319 2 25,249
IL $560 $100 $3,223 3 26,491
SD $516 $90 $5,085 2 11,088
VA $489 $111 $3,592 1 6,983
MS $488 $65 $4,156 3 7,121
IN $364 $81 $2,014 13 110,204
TX $350 $83 $1,413 17 63,303
OR $346 $146 $1,467 1 6,020
WI $325 $226 $325 2 5
LA $299 $66 $1,520 7 56,164
SC $265 $67 $1,951 1 10,995
FL $263 $263 $446 4 522
CO $240 $74 $792 2 15,895
AZ $193 $93 $491 2 116
AL $191 $22 $649 5 20,895
MI $181 $45 $768 2 35,829
CT $165 $30 $736 1 12,857
NH $142 $51 $428 1 19,575
IA $126 $39 $438 5 20,315
TN $108 $73 $173 5 28
NV $87 $27 $305 1 4,782
KS $81 $30 $277 1 5,872
OK $41 $12 $144 2 5,311
NE — — — 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
       
PHYSICIANS' MEDICAL CENTER LLC IN New Albany $14,443 $3,445 $15,224 277 554
ORTHOINDY HOSPITAL IN Indianapolis $10,506 $4,100 $14,350 181 202
OSF HEART OF MARY MEDICAL CENTER IL Urbana $6,978 $6,497 $7,459 2 2
NORTHWEST MISSISSISSIPPI REGIONAL MEDICAL CENTER MS Clarksdale $6,829 $604 $14,637 1,549 1,566
PHYSICIANS CARE SURGICAL HOSPITAL PA Royersford $6,102 $1,493 $11,093 4,278 4,376
ARKANSAS SURGICAL HOSPITAL AR No Little Rock $5,763 $1,481 $17,312 666 2,252
WINN PARISH MEDICAL CENTER LA Winnfield $5,417 $42 $12,099 1,554 3,110
MONUMENT HEALTH SPEARFISH HOSPITAL SD Spearfish $3,792 $31 $11,813 890 1,780
Adventhealth Port Charlotte FL Port Charlotte $3,667 $1,894 $21,507 4 4
OAKDALE COMMUNITY HOSPITAL LA Oakdale $3,599 $26 $10,743 1,758 1,836
NEWTON MEDICAL CENTER NJ Newton $3,133 $185 $8,305 6,904 21,954
CEDAR COUNTY MEMORIAL HOSPITAL MO El Dorado Springs $2,635 $89 $2,839 2,415 2,517
OSS ORTHOPAEDIC HOSPITAL PA York $2,356 $1,211 $3,860 3 3
AHS HOSPITAL CORP NJ Hackettstown $2,350 $143 $8,305 6,849 23,323
CHILTON MEDICAL CENTER NJ Pompton Plains $2,164 $143 $7,557 7,033 15,810
OVERLOOK MEDICAL CENTER NJ Summit $2,120 $146 $8,475 7,197 24,505
NATIONAL PARK MEDICAL CENTER AR Hot Springs $2,000 $2,000 $2,000 1 1
CENTRAL CAROLINA HOSPITAL NC Sanford $1,928 $45 $6,331 2,855 3,020
Goshen Surgery Center — — $1,751 $1,208 $2,376 1,957 3,914
CENTRASTATE MEDICAL CENTER NJ Freehold $1,690 $132 $6,950 7,196 17,059

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