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

Highmark BCBS

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.

$303 Overall median paid
237 hospitals
10,617,092 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 $4,459,950 $4,505,000 ↓ 1.0% 18 86
J1411 HCPCS Inj, Hemgenix, Per Tx Dose $3,927,000 $3,685,267 ↑ 6.6% 21 212
J1414 HCPCS Inj, Beqvez, Per Tx Dose $3,927,000 $3,508,750 ↑ 11.9% 13 193
J1413 HCPCS Inj Delandistrogene Mox Rokl $3,590,400 $3,325,455 ↑ 8.0% 21 220
J3394 HCPCS Inj, Lovotibeglogene Autotem $3,478,200 $3,248,446 ↑ 7.1% 19 216
J3393 HCPCS Inj, Betibeglogene Autotemce $3,141,600 $2,968,000 ↑ 5.8% 19 227
J3399 HCPCS Inj Onase Abepar-xioi Treat $2,554,248 $2,455,111 ↑ 4.0% 22 257
J3392 HCPCS Inj, Exagamglogene Autotem $2,468,400 $2,332,000 ↑ 5.8% 18 257
Q2057 HCPCS Afamitresgene Autoleucel $815,694 $813,967 ↑ 0.2% 25 310
Q2056 HCPCS Ciltacabtagene Car-pos T $688,852 $599,737 ↑ 14.9% 32 341
Q2055 HCPCS Idecabtagene Vicleucel Car $657,039 $574,037 ↑ 14.5% 33 342
Q2054 HCPCS Lisocabtagene Mara Car Pos T $643,117 $579,571 ↑ 11.0% 35 358
Q2042 HCPCS Tisagenlecleucel Car-pos T $601,458 $621,313 ↓ 3.2% 35 365
Q2041 HCPCS Axicabtagene Ciloleucel Car+ $554,400 $562,501 ↓ 1.4% 34 345
Q2053 HCPCS Brexucabtagene Car Pos T $513,923 $513,770 ↑ 0.0% 34 414
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies $426,860 $168,055 ↑ 154.0% 115 438
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft $274,902 $131,925 ↑ 108.4% 119 578
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc $274,399 $186,516 ↑ 47.1% 119 519
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Neck With Major O.r. Procedures $213,860 $145,435 ↑ 47.0% 140 690
C1713 HCPCS — $596 $1,045 ↓ 43.0% 67 233,469

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
       
OH $3,178 $696 $12,058 4 40,973
AL $1,408 $257 $2,810 1 3,533
ID $677 $167 $2,261 1 101,520
IN $659 $39 $16,623 1 5,386
WV $643 $120 $3,291 36 936,208
MA $631 $133 $2,319 1 104,604
NJ $625 $111 $3,765 7 175,478
MI $425 $97 $1,194 2 211,372
IA $311 $61 $2,868 11 56,262
PA $303 $55 $2,106 139 7,305,263
TX $272 $93 $951 1 1,703
DE $272 $41 $1,713 9 33,024
NY $238 $50 $1,179 23 1,632,707
MD $60 $20 $235 1 9,059

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
       
Good Shepherd Specialty Hospital PA Bethlehem $57,738 $50,428 $65,047 76 152
PENNSYLVANIA HOSPITAL PA Philadelphia $21,106 $13,425 $36,237 766 1,530
ALLEGHENY GENERAL HOSPITAL PA Pittsburgh $20,763 $11,710 $38,052 774 13,968
CHRISTIANA HOSPITAL DE Newark $20,668 $12,392 $39,617 521 554
The Hospital of the University of Pennsylvania PA Philadelphia $16,572 $13,975 $19,169 2 2
OSS ORTHOPAEDIC HOSPITAL PA York $14,836 $9,504 $25,573 802 3,275
Kindred Hospital Philadelphia - Havertown PA Lawncrest $14,567 $14,567 $14,567 1 1
EXCELA HEALTH - FRICK HOSPITAL PA Mount Pleasant $14,477 $9,201 $25,731 770 5,370
PHYSICIANS CARE SURGICAL HOSPITAL PA Royersford $10,329 $3,193 $18,753 4,889 31,822
Penn Highlands Clearfield PA Clearfield $9,183 $4,977 $16,459 181 181
PENN HIGHLANDS DUBOIS PA Dubois $9,183 $4,977 $16,459 181 181
COMMUNITY MEMORIAL HOSPITAL, INC NY Hamilton $5,655 $544 $14,106 35 68
AHN EMERUS WESTMORELAND, LLC PA Greensburg $5,435 $171 $12,495 2,364 7,388
PENN HIGHLANDS HUNTINGDON PA Huntingdon $5,375 $492 $8,549 77 77
TRINITY MEDICAL CTR EAST &TRINITY MEDICAL CTR WEST OH Steubenville $4,817 $639 $12,417 6,362 38,142
CAMC CHARLESTON SURGICAL HOSPITAL WV Charleston $3,538 $1,776 $7,103 160 320
JEFFERSON EINSTEIN PHILADELPHIA HOSPITAL PA Philadelphia $3,443 $281 $8,396 6,638 26,552
JEFFERSON EINSTEIN MONTGOMERY HOSPITAL PA East Norriton $3,344 $273 $8,071 6,638 26,552
ADVANCED SURGICAL HOSPITAL PA Washington $3,312 $479 $8,267 6,412 51,939
ROTHMAN ORTHOPAEDIC SPECIALTY HOSPITAL PA Bensalem $3,260 $1,603 $16,891 974 1,226

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