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

Oscar Health

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.

$807 Overall median paid
563 hospitals
1,304,261 distinct codes
9,807,971 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
       
J1411 HCPCS — $4,422,320 $3,710,000 ↑ 19.2% 29 37
J3394 HCPCS — $4,287,948 $3,286,000 ↑ 30.5% 53 68
J1413 HCPCS — $4,221,882 $3,325,455 ↑ 27.0% 50 87
J3393 HCPCS — $3,888,377 $3,006,423 ↑ 29.3% 54 69
J3392 HCPCS — $3,498,000 $2,448,600 ↑ 42.9% 71 112
J3399 HCPCS — $3,240,746 $2,469,189 ↑ 31.2% 85 127
Q2057 HCPCS — $1,017,218 $824,563 ↑ 23.4% 56 114
Q2042 HCPCS — $873,778 $754,974 ↑ 15.7% 126 260
Q2054 HCPCS — $845,390 $674,188 ↑ 25.4% 125 222
Q2056 HCPCS — $830,068 $675,122 ↑ 23.0% 110 205
Q2041 HCPCS — $799,615 $634,511 ↑ 26.0% 110 208
Q2055 HCPCS — $735,660 $625,184 ↑ 17.7% 126 272
Q2053 HCPCS — $734,580 $620,080 ↑ 18.5% 111 205
18 MS_DRG — $439,242 $370,174 ↑ 18.7% 302 465
1 MS_DRG — $315,477 $265,286 ↑ 18.9% 284 399
927 MS_DRG — $265,689 $206,368 ↑ 28.7% 255 337
3 MS_DRG — $261,509 $202,986 ↑ 28.8% 278 392
4 MS_DRG — $173,467 $133,176 ↑ 30.3% 280 388
C1776 HCPCS — $3,063 $3,432 ↓ 10.7% 183 65,476
C1713 HCPCS — $536 $836 ↓ 35.9% 202 281,070

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
       
ME $15,145 $10,517 $19,773 1 2
OR $2,570 $2,570 $2,570 1 1
AZ $2,326 $200 $4,674 29 379,415
OK $2,034 $132 $4,387 4 74,703
NV $1,367 $152 $25,910 2 3,769
CA $1,155 $222 $8,596 14 138,893
SD $1,110 $110 $3,931 1 2,052
FL $1,051 $112 $6,934 110 1,440,075
TX $935 $103 $4,282 115 2,820,360
NY $807 $136 $3,900 36 943,204
MO $777 $64 $3,886 16 193,966
NJ $709 $115 $5,071 8 203,232
IL $695 $116 $4,800 19 302,295
KS $681 $108 $4,050 9 42,112
NM $600 $600 $600 1 1
NE $541 $121 $4,137 5 9,740
TN $533 $30 $3,130 39 715,864
GA $508 $63 $5,282 32 487,973
CO $487 $200 $2,159 1 930
PA $434 $66 $2,238 26 575,221
VA $422 $64 $2,651 4 89,420
MI $402 $96 $1,112 4 66,934
MN $284 $80 $1,192 8 55,923
WI $280 $69 $1,221 7 57,289
IA $196 $42 $983 20 103,386
NC $148 $38 $681 18 404,158
OH $104 $7 $1,049 25 584,424
CT $21 $2 $255 2 63,412
AR $2 <$1 $41 2 25,239
MS $2 <$1 $33 1 23,483
AL <$1 <$1 <$1 3 495

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
       
Kindred Hospital San Antonio TX San Antonio $153,639 $93,609 $214,363 3 3
Kindred Hospital Houston Medical Center TX Houston $135,314 $135,314 $135,314 1 1
Kindred Hosptial El Paso TX El Paso $114,362 $43,840 $184,884 2 4
Cornerstone Specialty Hospitals Austin TX Austin $57,071 $57,071 $57,071 1 1
MOUNT SINAI SOUTH NASSAU NY Oceanside $32,864 $19,433 $54,152 846 848
Encompass Health Rehabilitation Hospital Of Cincin OH Cincinnati $28,689 $22,816 $35,950 380 760
ClearSky Rehabilitation Hospital of Baytown TX Baytown $26,817 $21,327 $33,605 380 1,140
Midamerica Rehabilitation Hospital KS Overland Park $26,532 $21,100 $33,247 380 760
MEMORIAL HERMANN - TEXAS MEDICAL CENTER TX Houston $26,404 $19,541 $39,897 804 1,581
Memorial Hermann Hospital TX Houston $26,404 $19,541 $39,897 804 1,581
MEMORIAL HERMANN NORTHEAST HOSPITAL TX Humble $26,167 $19,135 $38,814 787 794
Adventhealth Connerton FL Land O' Lakes $26,129 $17,310 $41,980 773 773
Kansas Rehabilitation Hospital, A Joint Venture Of KS Topeka $24,428 $19,427 $30,611 380 760
Orlando Health Dr. P. Phillips Hospital FL Orlando $21,346 $10,305 $42,925 330 330
ORLANDO HEALTH SEBASTIAN RIVER HOSPITAL FL Sebastian $20,548 $14,255 $36,777 170 170
Roosevelt Warm Springs Rehabilitation Hospital GA Warm Springs $20,076 $20,076 $20,076 1 1
ORLANDO HEALTH MELBOURNE HOSPITAL FL Melbourne $19,418 $12,533 $35,293 182 182
Kindred Hospital- San Antonio Central TX San Antonio $19,180 $19,180 $19,180 1 1
ORLANDO HEALTH-HEALTH CENTRAL HOSPITAL FL Ocoee $15,997 $8,548 $26,774 105 210
HOUSTON METHODIST HOSPITAL TX Houston $15,358 $10,377 $24,628 774 776

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