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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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.

$271 Overall median paid
216 hospitals
394,354 distinct codes
11,820,091 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
       
C1713 HCPCS — $576 $836 ↓ 31.1% 40 223,120
3 MS_DRG — $232,055 $202,986 ↑ 14.3% 88 574
927 MS_DRG — $312,392 $206,368 ↑ 51.4% 76 449
1 MS_DRG — $333,926 $265,286 ↑ 25.9% 74 410
18 MS_DRG — $462,000 $370,174 ↑ 24.8% 70 311
Q2053 HCPCS — $509,309 $620,080 ↓ 17.9% 30 358
Q2041 HCPCS — $554,400 $634,511 ↓ 12.6% 29 354
Q2042 HCPCS — $601,458 $754,974 ↓ 20.3% 30 364
Q2054 HCPCS — $643,117 $674,188 ↓ 4.6% 29 354
Q2055 HCPCS — $657,039 $625,184 ↑ 5.1% 30 357
Q2056 HCPCS — $688,852 $675,122 ↑ 2.0% 29 356
Q2057 HCPCS — $815,694 $824,563 ↓ 1.1% 20 319
J3392 HCPCS — $2,468,400 $2,448,600 ↑ 0.8% 13 255
J3399 HCPCS — $2,554,248 $2,469,189 ↑ 3.4% 17 257
J3393 HCPCS — $3,141,600 $3,006,423 ↑ 4.5% 14 226
J3394 HCPCS — $3,478,200 $3,286,000 ↑ 5.8% 14 217
J1413 HCPCS — $3,590,400 $3,325,455 ↑ 8.0% 17 225
J1411 HCPCS — $3,927,000 $3,710,000 ↑ 5.8% 14 210
J1414 HCPCS — $3,927,000 $3,710,000 ↑ 5.8% 11 207
J3391 HCPCS — $4,135,205 $4,505,000 ↓ 8.2% 13 80

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 $3,383 $650 $12,119 3 40,144
ID $676 $167 $2,261 1 101,568
NJ $638 $100 $4,002 7 195,814
MA $628 $132 $2,316 1 104,706
WV $539 $108 $2,814 31 1,003,913
MI $423 $96 $1,192 2 211,756
IA $288 $53 $2,750 11 58,362
PA $271 $49 $1,894 129 8,437,515
DE $248 $49 $1,218 6 51,569
NY $232 $50 $1,144 23 1,606,590
MD $66 $19 $263 2 8,154

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
ROTHMAN ORTHOPAEDIC SPECIALTY HOSPITAL PA Bensalem $41,200 $29,525 $53,686 36 178
CHRISTIANA HOSPITAL DE Newark $20,668 $12,392 $39,617 521 554
OSS ORTHOPAEDIC HOSPITAL PA York $14,843 $9,558 $25,558 799 3,246
Kindred Hospital Philadelphia - Havertown PA Lawncrest $14,567 $14,567 $14,567 1 1
PHYSICIANS CARE SURGICAL HOSPITAL PA Royersford $12,618 $3,356 $23,941 4,794 15,676
UNION HOSPITAL OF CECIL COUNTY MD Elkton $10,007 $7,825 $13,871 39 40
PENN HIGHLANDS DUBOIS PA Dubois $9,183 $4,977 $16,459 181 181
Penn Highlands Clearfield PA Clearfield $9,183 $4,977 $16,459 181 181
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
COMMUNITY MEMORIAL HOSPITAL, INC NY Hamilton $4,823 $585 $13,387 37 72
TRINITY MEDICAL CTR EAST &TRINITY MEDICAL CTR WEST OH Steubenville $4,817 $639 $12,417 6,362 38,142
PENN HIGHLANDS TYRONE PA Tyrone $3,901 $1,800 $8,755 47 47
PENN HIGHLANDS STATE COLLEGE PA State College $3,901 $1,800 $8,755 47 47
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
PENN HIGHLANDS BROOKVILLE PA Brookville $3,404 $902 $7,005 48 48
JEFFERSON EINSTEIN MONTGOMERY HOSPITAL PA East Norriton $3,344 $273 $8,071 6,638 26,552
ADVANCED SURGICAL HOSPITAL PA Washington $3,312 $843 $6,846 5,677 39,068

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