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

Medicaid (Generic)

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.

$356 Overall median paid
578 hospitals
7,230,685 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
       
J1413 HCPCS Inj Delandistrogene Mox Rokl $3,202,781 $3,324,572 ↓ 3.7% 4 12
J3399 HCPCS Inj Onase Abepar-xioi Treat $1,170,000 $2,466,282 ↓ 52.6% 7 58
Q2042 HCPCS Tisagenlecleucel Car-pos T $1,123,572 $738,272 ↑ 52.2% 9 45
5834 APR_DRG — $290,475 $307,273 ↓ 5.5% 101 176
5884 APR_DRG — $245,639 $247,214 ↓ 0.6% 101 176
5833 APR_DRG — $228,713 $244,017 ↓ 6.3% 104 179
24 APR_DRG — $223,960 $241,915 ↓ 7.4% 114 230
74 APR_DRG — $193,881 $170,172 ↑ 13.9% 97 164
6304 APR_DRG — $179,072 $154,011 ↑ 16.3% 98 173
1614 APR_DRG — $175,909 $202,993 ↓ 13.3% 106 185
5883 APR_DRG — $169,646 $175,429 ↓ 3.3% 98 173
5832 APR_DRG — $169,427 $159,249 ↑ 6.4% 98 173
6094 APR_DRG — $165,000 $165,000 0% 101 176
8414 APR_DRG — $164,998 $156,153 ↑ 5.7% 104 180
5914 APR_DRG — $161,393 $162,514 ↓ 0.7% 101 176
6314 APR_DRG — $154,837 $133,164 ↑ 16.3% 98 173
5934 APR_DRG — $151,678 $151,838 ↓ 0.1% 101 176
23 APR_DRG — $125,406 $111,046 ↑ 12.9% 111 219
C1776 HCPCS — $2,657 $3,390 ↓ 21.6% 85 29,993
C1713 HCPCS — $574 $862 ↓ 33.4% 97 90,701

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 $14,325 $8,158 $25,850 1 2,597
VA $14,295 $8,836 $26,277 4 3,271
MS $2,882 $77 $2,882 10 83,541
WV $1,806 $90 $6,786 2 9,577
AZ $1,500 $78 $6,574 7 15,086
UT $1,266 $547 $2,660 12 1,612,716
CA $1,155 $41 $5,278 7 32,315
SC $908 $701 $954 16 156,614
MA $809 $131 $5,491 19 244,716
CT $662 $342 $1,069 1 14
NY $582 $86 $2,638 20 92,599
SD $522 $177 $1,783 2 17,529
RI $484 $60 $3,684 2 12,025
DC $391 $83 $7,311 1 4,999
IL $388 $70 $2,629 21 249,898
MD $388 $114 $1,130 1 26,865
IN $356 $69 $1,729 44 1,097,446
WA $352 $53 $4,012 6 42,410
NE $349 $69 $3,675 7 21,393
NV $319 $96 $994 3 75,597
FL $295 $27 $2,461 22 132,971
PA $280 $30 $4,412 24 140,104
ME $265 $68 $3,396 4 8,275
NJ $253 $26 $5,565 10 194,949
MN $223 $60 $968 15 88,698
WI $223 $41 $1,515 7 30,943
MI $221 $53 $858 37 581,918
OH $176 $31 $1,242 21 115,758
NM $169 $21 $2,618 7 26,020
IA $169 $55 $594 2 2,341
NH $154 $44 $440 3 97,307
ID $150 $90 $310 4 137
WY $144 $26 $699 4 4,703
NC $141 $27 $1,823 2 5,894
TX $127 $20 $1,559 57 255,831
GA $118 $24 $663 14 244,502
LA $109 $17 $1,043 43 848,191
OR $104 $22 $459 4 70,365
MT $102 $40 $312 4 2,590
KS $101 $18 $616 10 43,185
ND $91 $28 $301 3 7,873
MO $77 $16 $374 26 239,648
DE $55 $30 $185 1 1,346
OK $44 $12 $240 24 66,916
AL $43 $12 $287 13 60,490
AR $40 $14 $250 20 100,308
TN $32 $7 $145 2 7,579
PR $30 $20 $115 1 217
CO $17 $3 $139 7 50,416
AK $11 $11 $11 1 2

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
       
PALI MOMI MEDICAL CENTER HI Aiea $14,325 $8,158 $25,850 1,428 2,597
TUFTS MEDICAL CENTER MA Boston $15,256 $9,795 $24,277 785 2,384
Lowell General Hospital - Saints Campus MA Lowell $14,664 $9,382 $23,208 783 2,367
MELROSEWAKEFIELD HEALTHCARE MA Melrose $14,112 $8,996 $22,679 769 2,335
REEDSBURG AREA MEDICAL CENTER WI Reedsburg $39,178 $3,183 $61,463 1,986 1,986
BRYAN MEDICAL CENTER NE Lincoln $9,104 $2,877 $19,550 1,967 1,967
GRAND ISLAND REGIONAL MEDICAL CENTER NE Grand Island $9,104 $2,877 $19,550 1,967 1,967
UNIVERSITY OF VIRGINIA MEDICAL CENTER VA Charlottesville $17,795 $10,254 $33,405 316 1,860
MOBERLY REGIONAL MEDICAL CENTER MO Moberly $10,524 $4,973 $21,390 1,687 1,687
ANN & ROBERT H LURIE CHILDRENS HOSPITAL OF CHICAGO IL Chicago $8,402 $4,577 $15,281 1,349 1,349
JASPER GENERAL HOSPITAL MS Bay Springs $9,437 $5,219 $16,936 1,347 1,347
Ohio State University Hospitals OH Columbus $11,322 $6,609 $20,134 1,324 1,324
MERCY HOSPITAL MN Coon Rapids $16,666 $9,064 $29,664 1,322 1,322
Vibra Hospital Of Southeastern Massachusetts MA New Bedford $35,568 $31,440 $52,331 740 740
NOVANT PRINCE WILLIAM MEDICAL CENTER VA Manassas $12,321 $7,889 $19,379 180 710
UVA HEALTH CULPEPER MEDICAL CENTER VA Culpeper $10,211 $7,615 $16,013 114 441
Iberia Rehabilitation Hospital LA Lafayette $26,304 $20,796 $32,548 380 380
UVA HEALTH HAYMARKET MEDICAL CENTER VA Haymarket $11,853 $8,478 $17,809 89 260
WESTERN MISSOURI MEDICAL CENTER MO Warrensburg $8,370 $5,854 $12,805 78 78
CHILDREN'S HOSP OF LOS ANGELES CA Los Angeles $26,686 $17,924 $32,038 40 40

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