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

UPMC Health Plan

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.

$425 Overall median paid
276 hospitals
532,179 distinct codes
9,287,430 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
       
J1414 HCPCS — $3,932,600 $3,710,000 ↑ 6.0% 12 20
J1411 HCPCS — $3,906,383 $3,710,000 ↑ 5.3% 18 27
J3394 HCPCS — $3,483,160 $3,286,000 ↑ 6.0% 17 26
J1413 HCPCS — $3,325,455 $3,325,455 0% 22 42
J3393 HCPCS — $3,125,106 $3,006,423 ↑ 3.9% 17 26
J3399 HCPCS — $2,690,571 $2,469,189 ↑ 9.0% 23 45
J3392 HCPCS — $2,471,920 $2,448,600 ↑ 1.0% 16 25
Q2042 HCPCS — $695,717 $754,974 ↓ 7.8% 49 135
Q2056 HCPCS — $678,122 $675,122 ↑ 0.4% 32 83
Q2055 HCPCS — $557,318 $625,184 ↓ 10.9% 42 102
18 MS_DRG — $357,812 $370,174 ↓ 3.3% 120 250
1 MS_DRG — $238,193 $265,286 ↓ 10.2% 122 266
C1882 HCPCS — $43,635 $27,112 ↑ 60.9% 73 2,781
C1820 HCPCS — $39,449 $22,013 ↑ 79.2% 64 1,549
C1767 HCPCS — $38,534 $22,478 ↑ 71.4% 75 2,020
C1721 HCPCS — $32,497 $22,210 ↑ 46.3% 72 2,222
C1722 HCPCS — $30,983 $20,768 ↑ 49.2% 69 2,240
C1874 HCPCS — $7,812 $4,694 ↑ 66.4% 83 9,847
C1776 HCPCS — $5,141 $3,432 ↑ 49.8% 87 82,407
C1713 HCPCS — $1,264 $836 ↑ 51.2% 90 224,327

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
       
CO $13,588 $8,960 $21,882 2 785
IN $1,829 $289 $5,627 2 2,837
NC $1,080 $1,080 $1,080 1 1
MT $1,062 $264 $4,294 1 1,880
IA $1,000 $1,000 $1,000 1 1
FL $835 $102 $3,813 24 605,173
NJ $703 $189 $3,240 2 72,472
NM $600 $600 $600 1 1
UT $512 $147 $1,362 3 43,439
WV $438 $55 $3,393 8 141,784
PA $425 $57 $2,438 147 7,678,981
OR $412 $158 $2,316 1 13,009
TN $369 $74 $1,608 8 44,929
AZ $332 $35 $7,947 19 61,756
MN $288 $81 $1,225 9 63,999
WI $270 $67 $1,206 7 94,061
NY $259 $42 $2,280 14 139,787
DE $214 $59 $914 1 7,828
SC $189 $24 $2,969 2 4,795
OH $129 $9 $1,500 15 240,527
MD $69 $20 $273 1 15,835
AR $50 $10 $209 7 53,550
ME — — — 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
       
Kindred Hospital Philadelphia - Havertown PA Lawncrest $71,610 $71,610 $71,610 1 1
TIDELANDS GEORGETOWN MEMORIAL HOSPITAL SC Georgetown $22,982 $15,997 $38,913 313 313
ROTHMAN ORTHOPAEDIC SPECIALTY HOSPITAL PA Bensalem $21,391 $15,483 $30,153 36 62
KALEIDA HEALTH NY Buffalo $20,800 $13,667 $34,271 770 773
BLYTHEDALE CHILDREN'S HOSPITAL NY Valhalla $20,800 $13,667 $34,271 770 773
GARNET HEALTH MEDICAL CENTER NY Middletown $17,733 $11,603 $29,246 772 772
GARNET HEALTH MEDICAL CENTER CATSKILLS NY Harris $16,328 $10,772 $26,709 772 773
Bryn Mawr Rehab PA Malvern $15,000 $3,387 $27,669 6 10
Adventhealth Orlando FL Orlando $14,377 $9,780 $22,858 777 778
MAIN LINE HOSPITAL LANKENAU PA Wynnewood $14,243 $8,393 $23,901 857 1,186
AdventHealth Parker CO Parker $13,717 $9,246 $22,177 770 770
BRYN MAWR HOSPITAL PA Bryn Mawr $13,621 $8,181 $22,225 854 1,975
BROOKS-TLC HOSPITAL SYSTEM, INC NY Dunkirk $12,275 $87 $25,245 1,709 2,479
RIDDLE MEMORIAL HOSPITAL PA Media $12,213 $7,269 $19,510 825 1,878
PAOLI HOSPITAL PA Paoli $12,191 $7,214 $19,731 822 949
BANNER BEHAVIORAL HEALTH HOSPITAL AZ Scottsdale $11,330 $157 $18,965 1,081 1,081
NAPLES COMMUNITY HOSPITAL FL Naples $10,122 $3,837 $15,261 23 48
PHYSICIANS CARE SURGICAL HOSPITAL PA Royersford $8,303 $2,197 $13,273 4,811 14,752
PENN HIGHLANDS DUBOIS PA Dubois $7,800 $3,974 $14,321 432 877
Penn Highlands Clearfield PA Clearfield $7,800 $3,974 $14,321 432 877

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