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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HEALTHSMART BENEFIT SOLUTIONS

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.

$835 Overall median paid
441 hospitals
1,433,006 distinct codes
11,099,692 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 — $3,506,334 $2,469,189 ↑ 42.0% 34 82
J3392 HCPCS — $3,402,085 $2,448,600 ↑ 38.9% 27 73
Q2041 HCPCS — $1,433,521 $634,511 ↑ 125.9% 58 94
Q2056 HCPCS — $1,397,896 $675,122 ↑ 107.1% 52 124
Q2042 HCPCS — $1,382,053 $754,974 ↑ 83.1% 63 144
Q2055 HCPCS — $1,327,168 $625,184 ↑ 112.3% 63 162
Q2054 HCPCS — $1,318,860 $674,188 ↑ 95.6% 65 132
Q2053 HCPCS — $1,219,680 $620,080 ↑ 96.7% 65 134
C1882 HCPCS — $36,072 $27,112 ↑ 33.0% 169 6,015
C1767 HCPCS — $35,539 $22,478 ↑ 58.1% 169 5,855
C1820 HCPCS — $29,796 $22,013 ↑ 35.4% 160 5,100
C1721 HCPCS — $29,462 $22,210 ↑ 32.7% 171 5,359
C1722 HCPCS — $28,610 $20,768 ↑ 37.8% 170 6,052
C1874 HCPCS — $6,956 $4,694 ↑ 48.2% 185 33,889
C1776 HCPCS — $5,313 $3,432 ↑ 54.8% 202 300,659
C1889 HCPCS — $4,622 $2,393 ↑ 93.1% 198 70,175
C1876 HCPCS — $3,662 $2,443 ↑ 49.9% 185 29,739
C1768 HCPCS — $3,096 $2,048 ↑ 51.2% 186 39,876
C1781 HCPCS — $2,342 $1,362 ↑ 72.0% 193 70,443
C1713 HCPCS — $1,229 $836 ↑ 47.0% 197 854,217

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
       
HI $4,000 $852 $4,000 1 4,941
PA $3,004 $2,106 $3,004 2 6,535
MO $2,839 $245 $6,615 2 7,514
FL $1,920 $1,920 $1,931 3 4,264
IN $1,525 $461 $3,316 5 46,269
LA $1,403 $136 $3,914 6 222,715
WV $1,299 $309 $5,176 5 259,077
IL $1,261 $185 $3,519 13 297,255
VA $1,181 $494 $3,753 1 21,665
TN $1,148 $410 $3,874 5 205,211
CA $1,100 $105 $9,874 51 860,903
MT $1,062 $264 $4,294 1 1,880
TX $835 $143 $4,074 163 5,615,592
OR $785 $180 $9,414 1 2,453
NJ $648 $49 $5,834 6 156,996
NE $606 $164 $2,583 1 22,780
OK $599 $106 $3,919 24 280,671
MA $592 $114 $1,782 2 41,264
SC $539 $80 $19,444 1 2,597
KY $515 $55 $2,711 12 440,290
CO $479 $189 $2,155 2 989
AZ $436 $47 $2,779 2 16,440
NC $433 $178 $1,919 3 1,153
NM $384 $40 $3,154 9 128,554
NV $319 $107 $1,221 2 6,408
MN $292 $82 $1,243 9 64,413
MI $281 $42 $1,231 11 511,230
OH $249 $45 $1,350 59 1,345,578
WA $200 $155 $245 1 60
KS $200 $155 $245 1 60
WI $191 $20 $1,146 30 479,266
AR $159 $33 $562 2 20,318
WY $149 $48 $562 1 5,722
IA $134 $37 $545 2 10,513
GA $127 $46 $375 2 8,116

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
       
Kentfield Hospital CA Kentfield $71,000 $71,000 $71,000 735 735
COVENANT MEDICAL CENTER TX Lubbock $33,825 $21,894 $55,047 773 773
DOMINICAN HOSPITAL CA Santa Cruz $20,712 $1,518 $20,712 10,998 12,885
TEXAS INSTITUTE FOR SURGERY AT PRESBYTERIAN HOSPIT TX Dallas $16,000 $9,198 $16,000 5,015 6,093
UCSF HEALTH SAINT FRANCIS HOSPITAL CA San Francisco $15,801 $610 $18,261 10,753 12,603
SEQUOIA HOSPITAL CA Redwood City $14,790 $1,049 $18,562 10,619 25,678
UCSF HEALTH ST. MARY'S HOSPITAL CA San Francisco $14,619 $696 $26,822 11,715 28,364
KETTERING HEALTH DAYTON OH Dayton $14,076 $1,953 $51,875 6 9
SIERRA NEVADA MEMORIAL HOSPITAL CA Grass Valley $10,433 $386 $18,258 10,692 29,710
Arroyo Grande Community Hospital CA Arroyo Grande $9,665 $301 $15,376 12,188 16,435
ST BERNARDINE MEDICAL CENTER CA San Bernardino $9,489 $472 $13,100 12,712 16,506
COMMUNITY HOSPITAL EAST IN Indianapolis $9,270 $5,143 $18,516 2,333 2,333
MERCY SAN JUAN MEDICAL CENTER CA Carmichael $8,399 $340 $14,253 11,473 16,972
MERCY GENERAL HOSPITAL CA Sacramento $8,051 $317 $20,276 11,503 17,059
NORTHRIDGE HOSPITAL MEDICAL CENTER CA Northridge $7,896 $2,232 $14,166 13,510 31,528
MARIAN REGIONAL MEDICAL CENTER CA Santa Maria $7,643 $310 $15,376 12,648 18,472
BAKERSFIELD MEMORIAL HOSPITAL CA Bakersfield $7,341 $224 $12,473 13,224 19,312
MERCY HOSPITAL CA Bakersfield $7,339 $179 $11,912 12,791 19,022
CALIFORNIA HOSPITAL MEDICAL CENTER LA CA Los Angeles $6,955 $1,659 $13,330 10,503 12,223
FRENCH HOSPITAL MEDICAL CENTER CA San Luis Obispo $6,803 $334 $14,394 13,091 18,493

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