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Heart failure & shock w MCC

MS-DRG 291 · negotiated-rate distribution across hospitals in GA

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Hospitals
15
Min
$9,795.34
Median
$16,789
Max
$28,812
Range multiplier
2.9×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
healthpartners347$12,581$28,812$40,7403.2×
Blue Cross Blue Shield1142$36$17,654$39,4141094.8×
Aetna1131$90$21,224$32,081356.5×
UnitedHealthcare1027$8,132.12$15,103$54,2366.7×
Cigna1127$85$15,122$37,310438.9×
Humana1120$3,505.82$21,823$33,8149.6×
WellCare78$8,051.6$12,091$15,5761.9×
Oscar Health77$12,883$18,102$19,6341.5×
devoted health66$9,315.26$13,855$15,5561.7×
Ambetter55$13,285$27,792$30,9532.3×
Kaiser Permanente44$9,315.26$13,855$14,6011.6×
optum44$9,315.26$13,855$14,6011.6×
clover health44$9,781.02$14,548$15,3311.6×
sonder health plans44$9,781.02$14,548$15,3311.6×
va community care network44$9,315.26$13,855$14,6011.6×
First Health23$95$7,300$9,795.34103.1×
TRICARE23$8,522.69$8,522.69$9,749.131.1×
CareSource13$15,576$15,576$26,4301.7×
sonder health plan12$15,878$15,878$15,8781.0×
peach state12$12,568$14,072$15,5761.2×
riverwood behavioral health12$15,103$15,112$15,1221.0×
Health Net12$97$4,946.17$9,795.34101.0×
occunet11$18,116$18,116$18,1161.0×
pcc employee11$10,815$10,815$10,8151.0×
prime health services11$12,086$12,086$12,0861.0×
provider select11$12,335$12,335$12,3351.0×
rural arizona network11$9,795.34$9,795.34$9,795.341.0×
smarthealth11$11,272$11,272$11,2721.0×
ubh optum11$15,122$15,122$15,1221.0×
united mine workers of america11$9,795.34$9,795.34$9,795.341.0×
three rivers11$12,086$12,086$12,0861.0×
americas choice provider network11$12,086$12,086$12,0861.0×
arizona medical network11$9,795.34$9,795.34$9,795.341.0×
banner health11$9,795.34$9,795.34$9,795.341.0×
blue mcr replacement11$8,051.6$8,051.6$8,051.61.0×
bridgeway health solutions11$9,795.34$9,795.34$9,795.341.0×
centurion11$22,654$22,654$22,6541.0×
clear spring health plan11$15,103$15,103$15,1031.0×
corvel11$11,836$11,836$11,8361.0×
employer direct healthcare11$19,634$19,634$19,6341.0×
facility billing - op11$8,051.6$8,051.6$8,051.61.0×
georgia workers’ compensation11$12,459$12,459$12,4591.0×
health choice pathway11$9,795.34$9,795.34$9,795.341.0×
health management network11$9,795.34$9,795.34$9,795.341.0×
healthspring mcr replacement11$8,212.63$8,212.63$8,212.631.0×
imperial insurance11$10,285$10,285$10,2851.0×
Medicare11$15,103$15,103$15,1031.0×
Medicare Advantage11$8,051.6$8,051.6$8,051.61.0×
Multiplan11$12,086$12,086$12,0861.0×
naphcare11$23,410$23,410$23,4101.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
WEST CENTRAL GA REGIONAL HOSPITALCOLUMBUSGA17$36$9,795.34$54,236
NORTHEAST GEORGIA MEDICAL CENTERGAINESVILLEGA6$12,581$28,812$40,740
EMORY LONG TERM ACUTE CAREDECATURGA5$18,102$25,229$26,058
NGMC LUMPKIN LLCDAHLONEGAGA6$12,581$20,954$40,740
NGMC BARROWWINDERGA6$12,581$20,100$39,414
EMORY UNIVERSITY HOSPITALATLANTAGA14$13,458$16,789$30,953
EMORY UNIVERSITY HOSPITAL MIDTOWNATLANTAGA14$13,458$16,789$30,953
EMORY DECATURDECATURGA14$13,109$15,999$27,792
ST. JOSEPHS OF ATLANTAATLANTAGA14$9,315.26$15,780$27,703
SOUTHERN REGIONAL MEDICAL CENTERRIVERDALEGA28$15,102$3,505.82$15,122$26,430
ST. MARYS SACRED HEART HOSPITALLAVONIAGA17$7,300$10,470$19,155
MEMORIAL HOSPITALBAINBRIDGEGA0
SOUTHWELL MEDICALADELGA0
CHATUGE REGIONAL HOSPITALHIWASSEEGA0
UNION GENERAL HOSPITALBLAIRSVILLEGA0

Median is taken across all payer × plan combinations the hospital publishes. Cash and gross are the latest snapshot values. Range multiplier (max ÷ min) is a quick way to see which hospitals or payers vary the most.