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

Medica

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.

$202 Overall median paid
530 hospitals
17,195,190 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 $4,505,000 $4,505,000 0% 22 38
J1411 HCPCS Inj, Hemgenix, Per Tx Dose $3,685,267 $3,705,478 ↓ 0.5% 25 44
J1413 HCPCS Inj Delandistrogene Mox Rokl $3,316,463 $3,324,572 ↓ 0.2% 25 62
J3394 HCPCS Inj, Lovotibeglogene Autotem $3,248,446 $3,286,000 ↓ 1.1% 26 43
J3399 HCPCS Inj Onase Abepar-xioi Treat $1,530,000 $2,467,386 ↓ 38.0% 31 262
Q2056 HCPCS Ciltacabtagene Car-pos T $1,241,338 $646,415 ↑ 92.0% 38 236
Q2042 HCPCS Tisagenlecleucel Car-pos T $1,190,548 $739,258 ↑ 61.0% 33 313
Q2054 HCPCS Lisocabtagene Mara Car Pos T $1,132,510 $640,950 ↑ 76.7% 37 222
Q2041 HCPCS Axicabtagene Ciloleucel Car+ $1,051,770 $608,239 ↑ 72.9% 45 244
Q2053 HCPCS Brexucabtagene Car Pos T $1,040,759 $591,721 ↑ 75.9% 43 262
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies $467,960 $359,454 ↑ 30.2% 131 438
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc $299,091 $249,036 ↑ 20.1% 134 454
C1882 HCPCS — $23,840 $27,360 ↓ 12.9% 132 8,189
C1767 HCPCS — $21,423 $23,896 ↓ 10.3% 154 9,613
C1820 HCPCS — $21,394 $22,986 ↓ 6.9% 130 6,093
C1721 HCPCS — $19,958 $22,344 ↓ 10.7% 134 6,752
C1722 HCPCS — $19,466 $20,901 ↓ 6.9% 130 7,290
C1874 HCPCS — $3,780 $4,820 ↓ 21.6% 171 42,319
C1776 HCPCS — $2,758 $3,394 ↓ 18.7% 236 309,767
C1713 HCPCS — $627 $863 ↓ 27.4% 268 860,102

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 $1,880 $788 $1,896 3 10
MD $780 $159 $3,089 1 37,563
TN $650 $650 $650 1 3
IN $513 $144 $3,445 4 8,267
FL $493 $109 $1,969 17 341,681
CA $492 $112 $4,918 1 3,526
NE $458 $91 $2,161 64 2,913,469
IA $356 $81 $1,639 48 2,108,990
CO $346 $67 $2,245 7 50,080
WY $336 $81 $1,452 8 84,116
TX $294 $52 $2,806 3 4,137
OH $292 $178 $602 1 248
OK $287 $66 $1,239 50 844,875
MT $280 $43 $2,151 4 10,317
KY $272 $272 $272 2 2
KS $257 $46 $1,291 22 140,445
AR $245 $56 $1,691 2 7,270
MO $240 $45 $1,260 43 430,530
MI $232 $27 $1,208 4 376,175
SD $206 $62 $1,012 46 598,989
ND $202 $42 $1,061 34 868,350
MN $201 $39 $1,117 113 6,828,742
WI $164 $26 $845 38 1,243,947
DC $164 $41 $1,183 1 133,626
IL $151 $27 $947 11 148,777
UT $139 $36 $819 1 11,048
AL $89 $50 $284 1 7

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
       
OSF SAINT ANTHONY'S HEALTH CENTER IL Alton $62,947 $39,748 $104,325 787 787
Advanced Care Hospital Of Montana MT Billings $39,466 $30,580 $53,072 39 39
Kansas Rehabilitation Hospital, A Joint Venture Of KS Topeka $24,428 $19,427 $30,611 380 380
Encompass Health Rehab Hospital Of Sioux Falls SD Sioux Falls $23,728 $18,870 $29,733 380 380
LAKESIDE WOMEN'S HOSPITAL, A MEMBER OF INTEGRIS HE OK Oklahoma City $23,242 $19,157 $30,846 781 1,553
Altru Rehabilitation Hospital ND Grand Forks $23,078 $18,353 $28,919 380 380
MERCY HOSPITAL MN Coon Rapids $21,516 $12,538 $35,493 2,086 5,854
SSM HEALTH SAINT LOUIS UNIVERSITY HOSPITAL MO Saint Louis $16,481 $10,881 $26,523 824 1,632
PHYSICIANS' MEDICAL CENTER LLC IN New Albany $14,443 $3,445 $15,224 277 554
SSM HEALTH ST MARY'S HOSPITAL - ST LOUIS MO Saint Louis $14,166 $9,488 $22,809 823 1,627
INTEGRIS MIAMI HOSPITAL OK Miami $13,625 $9,468 $21,217 793 795
ST JOSEPH MEDICAL CENTER IL Bloomington $13,293 $8,811 $21,793 771 771
Integris Baptist Medical Center OK Oklahoma City $13,119 $8,725 $21,196 820 1,648
INTEGRIS GROVE HOSPITAL OK Grove $12,644 $8,594 $19,749 801 810
SSM HEALTH DEPAUL HOSPITAL ST LOUIS MO Bridgeton $12,611 $8,216 $20,163 833 1,653
INTEGRIS HEALTH PONCA CITY OK Ponca City $12,514 $8,363 $20,154 780 781
SSM ST JOSEPH HEALTH CENTER MO Saint Charles $12,470 $8,037 $19,809 825 1,643
INTEGRIS HEALTH ENID HOSPITAL OK Enid $12,383 $8,278 $19,613 797 801
INTEGRIS HEALTH EDMOND HOSPITAL OK Edmond $12,318 $8,127 $19,953 793 799
INTEGRIS CANADIAN VALLEY HOSPITAL OK Yukon $12,316 $8,208 $19,890 787 792

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