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

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.

$192 Overall median paid
460 hospitals
723,417 distinct codes
14,779,742 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 — $4,698,895 $4,505,000 ↑ 4.3% 16 17
J1413 HCPCS — $3,382,792 $3,325,455 ↑ 1.7% 19 41
J3399 HCPCS — $1,479,000 $2,469,189 ↓ 40.1% 24 244
Q2056 HCPCS — $1,241,338 $675,122 ↑ 83.9% 31 202
Q2042 HCPCS — $1,190,548 $754,974 ↑ 57.7% 24 257
Q2054 HCPCS — $1,137,422 $674,188 ↑ 68.7% 28 186
Q2041 HCPCS — $1,105,672 $634,511 ↑ 74.3% 30 188
Q2053 HCPCS — $1,074,611 $620,080 ↑ 73.3% 29 208
18 MS_DRG — $446,136 $370,174 ↑ 20.5% 107 324
1 MS_DRG — $333,579 $265,286 ↑ 25.7% 112 337
927 MS_DRG — $281,154 $206,368 ↑ 36.2% 109 325
3 MS_DRG — $239,102 $202,986 ↑ 17.8% 127 364
C1882 HCPCS — $22,982 $27,112 ↓ 15.2% 103 4,960
C1767 HCPCS — $19,997 $22,478 ↓ 11.0% 120 5,853
C1820 HCPCS — $19,908 $22,013 ↓ 9.6% 101 3,877
C1721 HCPCS — $19,383 $22,210 ↓ 12.7% 106 4,099
C1722 HCPCS — $18,785 $20,768 ↓ 9.5% 103 4,369
C1874 HCPCS — $3,362 $4,694 ↓ 28.4% 128 26,213
C1776 HCPCS — $2,692 $3,432 ↓ 21.6% 175 219,150
C1713 HCPCS — $644 $836 ↓ 23.0% 203 642,521

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
       
IN $7,585 $4,100 $19,475 2 453
NC $1,390 $750 $1,885 3 8
TN $650 $650 $650 1 3
CA $492 $112 $4,918 1 3,526
FL $477 $87 $2,400 15 171,190
NE $444 $89 $2,142 60 1,989,673
IA $353 $76 $1,685 40 1,571,072
CO $336 $67 $2,245 6 50,122
MI $316 $45 $1,369 3 307,857
TX $309 $54 $4,571 3 4,200
OK $300 $70 $1,260 42 858,535
OH $292 $178 $602 1 248
MO $280 $50 $1,524 38 363,886
KS $257 $44 $1,220 14 151,168
SD $251 $68 $1,347 35 575,167
WY $241 $63 $1,074 7 46,411
AR $212 $42 $1,054 2 13,336
ND $212 $40 $1,214 32 678,350
MT $209 $33 $2,132 4 15,426
WI $192 $40 $944 31 1,068,284
IL $162 $27 $1,112 11 143,985
MN $158 $33 $938 106 6,755,501
NY $156 $97 $380 1 266
UT $140 $36 $839 1 11,068
AL $89 $50 $284 1 7
KY — — — 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
       
OSF SAINT ANTHONY'S HEALTH CENTER IL Alton $62,947 $39,721 $104,410 787 1,574
LAKESIDE WOMEN'S HOSPITAL, A MEMBER OF INTEGRIS HE OK Oklahoma City $23,201 $19,063 $30,761 781 782
SSM HEALTH SAINT LOUIS UNIVERSITY HOSPITAL MO Saint Louis $16,481 $10,881 $26,523 824 1,632
SSM HEALTH ST MARY'S HOSPITAL - ST LOUIS MO Saint Louis $14,177 $9,489 $22,806 823 1,628
INTEGRIS MIAMI HOSPITAL OK Miami $13,625 $9,468 $21,283 793 1,590
ST JOSEPH MEDICAL CENTER IL Bloomington $13,293 $8,811 $21,793 771 771
Integris Baptist Medical Center OK Oklahoma City $12,975 $8,550 $21,028 820 849
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
ST LUKES HOSPITAL MN Duluth $12,537 $7,131 $24,350 873 2,907
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 $8,033 $19,820 825 3,286
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
SSM ST CLARE HEALTH CENTER MO Fenton $11,921 $7,777 $19,359 816 1,609
VIA CHRISTI HOSPITAL WICHITA ST TERESA, INC KS Wichita $10,731 $10,731 $10,731 842 842
ASCENSION VIA CHRISTI HOSPITALS WICHITA, INC. KS Wichita $10,639 $10,639 $10,731 854 3,392
ORTHOINDY HOSPITAL IN Indianapolis $10,506 $4,100 $14,350 181 202
WINONA HEALTH SERVICES MN Winona $10,045 $5,326 $16,625 940 1,990

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