Does Jefferson Methodist Hospital publish its standard charges and chargemaster?

Yes. Jefferson Methodist Hospital publishes a machine-readable file with 91,082 standard-charge rows — gross charges, cash prices, and payer-negotiated rates, earning a CMS price transparency compliance grade of A. Browse the negotiated rates by procedure and payer on this page.

How much does Jefferson Methodist Hospital charge for procedures?

Jefferson Methodist Hospital publishes a separately negotiated rate for each insurance payer, plus a discounted cash price and a gross (list) charge, for every procedure in its price transparency file. This page compares each procedure's negotiated median against the national median so you can see whether a price is above or below market.

▸ Hospital · · CCN 390205

Jefferson Methodist Hospital

Compliance grade

100/100

Rates published

91,082

last crawl 2026-05-24

Procedures tracked

197

of 209 target codes

Payers

with negotiated rates

Procedures tracked

...

Payers

...

▸ Compare with other hospitalsJSON

The report bundles all published codes × every payer rate + compliance grade as a downloadable PDF + CSV with a data-version manifest.

Source MRF: https://use2webtechstgpricelist.blob.core.windows.net/pricelist/Complete%20File/232829095_jefferson-methodist-hospital_standardcharges.csv · CSV

Procedures & rates

vs nat'l shows this hospital's negotiated median against the national median for that code (green = at/below market, amber = 1–1.5×, red = >1.5× the national median).

Procedure	Type	Code	Payers	Gross	Cash	Neg min	Neg median	vs nat'l	Neg max
behavioral
Psychoses	MS-DRG	885	27	—	$16,931	$2,569	$16,082	1.3×	$41,028
Psychiatric diagnostic evaluation	CPT	90791	1	$507	$209.7	$62.91	$62.91	0.36×	$62.91
Psychiatric eval with medical services	CPT	90792	1	—	—	$62.91	$62.91	0.36×	$62.91
Psychotherapy 30 minutes	CPT	90832	0	$572	$209.7	—	—	—	—
Psychotherapy 45 minutes	CPT	90834	0	$899	$209.7	—	—	—	—
Psychotherapy 60 minutes	CPT	90837	0	$1,138	$209.7	—	—	—	—
Crisis psychotherapy 60 minutes	CPT	90839	0	$158	$209.7	—	—	—	—
emergency
ED visit level 1	CPT	99281	6	$1,573	$99.62	$20.8	$1,319	9.4×	$2,391.15
ED visit level 2	CPT	99282	6	$2,095	$181.4	$39	$1,319	5.6×	$2,391.15
ED visit level 3	CPT	99283	6	$2,435	$322.51	$96.2	$1,319	3.3×	$2,484
ED visit level 4	CPT	99284	6	$3,088	$492.99	$153.4	$1,319	2.0×	$2,484
ED visit level 5	CPT	99285	5	$3,754	$703.6	$233	$1,550	1.5×	$3,709.12
Critical care, first hour	CPT	99291	9	$5,400	$975.93	$197.12	$1,319	1.2×	$7,623.86
imaging
CT head without contrast	CPT	70450	29	$1,953	$123.52	$91.84	$120.84	0.58×	$843.1
CT head with contrast	CPT	70460	29	$2,390	$207.23	$104	$178.4	0.76×	$1,090.95
CT head with and without contrast	CPT	70470	29	$2,779	$207.23	$130	$188.13	0.70×	$1,342.85
CT neck with contrast	CPT	70491	29	$3,785	$207.23	$107.25	$178.75	0.65×	$1,296.1
MRI brain without contrast	CPT	70551	29	$5,268	$281.9	$186.13	$319.89	0.79×	$2,403.3
MRI brain with contrast	CPT	70552	29	$6,843	$412.18	$239.71	$403.22	0.84×	$2,649.15
MRI brain with and without contrast	CPT	70553	29	$5,511	$412.18	$293.72	$403.22	0.68×	$3,408.95
Chest X-ray single view	CPT	71045	29	$400	$102.82	$10.54	$81.27	0.86×	$327.88
Chest X-ray 2 views	CPT	71046	29	$615	$102.82	$19.31	$82.07	0.83×	$327.88
Chest X-ray 3 views	CPT	71047	29	$676.5	$102.82	$24.57	$84.08	0.88×	$327.88
CT chest without contrast	CPT	71250	29	$2,307	$123.52	$91.84	$120.84	0.56×	$1,090.95
CT chest with contrast	CPT	71260	29	$2,874	$207.23	$113.75	$186.51	0.66×	$1,353
CT chest with and without contrast	CPT	71270	29	$3,401	$207.23	$134.55	$188.13	0.65×	$1,706.5
MRI chest without contrast	CPT	71550	29	$2,355	$281.9	$186.13	$319.89	0.74×	$2,663.35
MRI chest with contrast	CPT	71551	29	$3,060	$926.17	$239.71	$775.57	0.95×	$2,966.05
MRI chest with and without contrast	CPT	71552	29	$3,520	$412.18	$293.72	$467.73	0.78×	$4,028.55
Lumbosacral spine X-ray	CPT	72100	29	$551	$123.52	$24.64	$98.6	0.95×	$393.92
CT cervical spine without contrast	CPT	72125	29	$3,342	$123.52	$91.84	$120.84	0.60×	$1,095
CT thoracic spine without contrast	CPT	72128	29	$3,461	$123.52	$91.84	$120.84	0.61×	$1,092.95
CT lumbar spine without contrast	CPT	72131	29	$3,363	$123.52	$91.84	$120.84	0.59×	$1,090.95
MRI cervical spine without contrast	CPT	72141	29	$3,688	$281.9	$186.13	$319.89	0.81×	$2,116.85
MRI thoracic spine without contrast	CPT	72146	29	$3,688	$281.9	$186.13	$275.76	0.74×	$2,167.65
MRI lumbar spine without contrast	CPT	72148	29	$3,688	$281.9	$186.13	$275.76	0.73×	$2,165.65
MRI lumbar spine with and without contrast	CPT	72149	29	$4,790	$412.18	$239.71	$403.22	0.89×	$2,641
MRI cervical spine with and without contrast	CPT	72156	29	$5,511	$412.18	$293.72	$403.22	0.75×	$3,356.1
MRI lumbar spine with contrast	CPT	72158	29	$5,511	$412.18	$293.72	$403.22	0.74×	$3,352.05
CT pelvis without contrast	CPT	72192	29	$2,955	$123.52	$87.75	$120.83	0.60×	$1,034.05
CT pelvis with contrast	CPT	72193	29	$3,165	$207.23	$112.45	$182.12	0.65×	$1,283.95
Shoulder X-ray	CPT	73030	29	$711	$102.82	$21.45	$82.07	0.88×	$327.88
Humerus X-ray	CPT	73060	29	$656	$102.82	$14.95	$82.07	0.92×	$327.88
Hand X-ray 3 views	CPT	73130	29	$664	$102.82	$14.95	$82.07	0.88×	$327.88
MRI upper extremity joint without contrast	CPT	73221	29	$5,090	$281.9	$186.13	$319.89	0.77×	$2,279.4
MRI upper extremity joint with and without contrast	CPT	73223	29	$2,625	$412.18	$293.72	$467.73	0.77×	$3,356.1
Knee X-ray 1-2 views	CPT	73560	29	$475	$102.82	$21.45	$82.07	0.88×	$327.88
Ankle X-ray 3 views	CPT	73610	29	$678	$102.82	$24.35	$82.07	0.89×	$327.88
MRI lower extremity joint without contrast	CPT	73721	29	$5,268	$281.9	$186.13	$319.89	0.68×	$2,328.15
MRI lower extremity joint with and without contrast	CPT	73723	29	$7,874	$412.18	$293.72	$467.73	0.74×	$3,345.95
CT abdomen without contrast	CPT	74150	29	$3,398	$123.52	$91.84	$120.84	0.64×	$1,025.9
CT abdomen with contrast	CPT	74160	29	$3,825	$207.23	$117	$186.51	0.65×	$1,460.7
CT abdomen with and without contrast	CPT	74170	29	$4,715	$207.23	$144.95	$199.59	0.60×	$1,997
CT abdomen and pelvis without contrast	CPT	74176	29	$2,998	$281.9	$131.39	$238.26	0.65×	$1,542.95
CT abdomen and pelvis with contrast	CPT	74177	29	$3,296	$412.18	$250.55	$356.03	0.65×	$2,102.7
CT abdomen and pelvis with and without contrast	CPT	74178	29	$3,921	$412.18	$306.45	$403.22	0.70×	$2,854.3
MRI abdomen without contrast	CPT	74181	29	$5,268	$281.9	$186.13	$319.89	0.82×	$2,120.95
MRI abdomen with and without contrast	CPT	74183	29	$7,874	$412.18	$293.72	$467.73	0.83×	$3,534.9
Abdominal ultrasound complete	CPT	76700	29	$1,779	$123.52	$52.97	$111.17	0.74×	$536.78
Abdominal ultrasound limited	CPT	76705	29	$1,156	$123.52	$48.75	$104.4	0.71×	$401.8
Retroperitoneal ultrasound complete	CPT	76770	29	$2,537	$123.52	$52.97	$106.34	0.74×	$501.8
Obstetric ultrasound first trimester	CPT	76801	29	$1,532	$123.52	$49.91	$107.11	0.76×	$533.67
Obstetric ultrasound after first trimester	CPT	76805	29	$354	$123.52	$52.97	$106.34	0.70×	$1,169
Obstetric ultrasound with fetal anatomy	CPT	76811	29	$351	$281.9	$83.67	$239.34	1.0×	$898.99
Transvaginal ultrasound	CPT	76830	29	$398	$123.52	$52.97	$104.4	0.71×	$550.13
Pelvic ultrasound complete	CPT	76856	29	$398	$123.52	$52.97	$104.4	0.73×	$485.5
Scrotal ultrasound	CPT	76870	29	$1,178	$123.52	$52.97	$104.4	0.80×	$471.3
Diagnostic mammography unilateral	CPT	77065	9	$393	$103.22	$80.12	$199.78	1.3×	$572.14
Diagnostic mammography bilateral	CPT	77066	9	$658	$132.47	$101.46	$254.56	1.3×	$722.95
Screening mammography bilateral	CPT	77067	9	$207	$109.22	$82.03	$209.31	1.3×	$583.37
EKG complete	CPT	93000	5	—	—	$24.99	$53.62	2.2×	$602
EKG tracing only	CPT	93005	7	$564	$69.7	$13.6	$18.72	0.16×	$602
EKG interpretation only	CPT	93010	1	—	—	$511	$556.5	30.7×	$602
Transthoracic echocardiogram complete	CPT	93306	8	$3,798	$645.57	$127.58	$314.22	0.52×	$3,260.93
Transthoracic echocardiogram	CPT	93307	8	$2,229	$281.9	$123.5	$265.05	1.1×	$2,422
Stress echocardiogram	CPT	93350	8	$1,645	$645.57	$60.45	$213.44	0.42×	$3,357
inpatient
Respiratory infections & inflammations w MCC	MS-DRG	177	27	—	$18,856	$12,783	$18,892	1.2×	$77,669
COPD w MCC	MS-DRG	190	27	—	$13,578	$9,000.93	$13,391	1.2×	$45,791
COPD w CC	MS-DRG	191	27	—	$10,507	$6,978.56	$10,191	1.2×	$36,486
COPD w/o CC/MCC	MS-DRG	192	27	—	$8,175.26	$5,354.68	$7,761.16	1.1×	$27,207
Simple pneumonia & pleurisy w CC	MS-DRG	194	27	—	$10,077	$6,678.92	$9,742.55	1.1×	$37,828
Simple pneumonia & pleurisy w/o CC/MCC	MS-DRG	195	27	—	$8,018.65	$5,166.93	$7,597.95	1.1×	$26,903
AMI discharged alive w MCC	MS-DRG	280	27	—	$19,336	$12,974	$19,392	1.2×	$69,441
AMI discharged alive w CC	MS-DRG	281	27	—	$11,390	$7,459.05	$11,111	1.1×	$44,062
AMI discharged alive w/o CC/MCC	MS-DRG	282	27	—	$9,116.04	$5,951.66	$8,741.58	1.1×	$31,006
Heart failure & shock w MCC	MS-DRG	291	27	—	$15,620	$10,394	$15,520	1.2×	$55,396
Heart failure & shock w CC	MS-DRG	292	27	—	$10,577	$6,994.66	$10,264	1.1×	$36,933
Heart failure & shock w/o CC/MCC	MS-DRG	293	27	—	$7,293.64	$4,599.83	$6,842.39	1.1×	$26,316
Cardiac arrhythmia w MCC	MS-DRG	308	27	—	$14,695	$9,636.24	$14,555	1.2×	$46,215
Cardiac arrhythmia w CC	MS-DRG	309	27	—	$9,262.2	$6,060.48	$8,893.9	1.1×	$31,120
Cardiac arrhythmia w/o CC/MCC	MS-DRG	310	27	—	$7,294.8	$4,682.6	$6,843.6	1.1×	$21,652
GI hemorrhage w CC	MS-DRG	378	27	—	$12,104	$7,950.28	$11,856	1.2×	$37,437
GI hemorrhage w/o CC/MCC	MS-DRG	379	27	—	$8,040.69	$5,274.21	$7,620.92	1.1×	$27,222
Esophagitis/gastroenteritis w/o MCC	MS-DRG	392	27	—	$9,771.45	$6,374.69	$9,424.6	1.2×	$26,244
Fractures of femur w/o MCC	MS-DRG	533	27	—	$18,914	$12,081	$18,952	1.2×	$59,275
Kidney/UTI w MCC	MS-DRG	689	27	—	$14,188	$9,363.42	$14,027	1.2×	$45,965
Kidney/UTI w/o MCC	MS-DRG	690	27	—	$10,118	$6,545.59	$9,786.07	1.2×	$29,228
Septicemia or severe sepsis w MV 96+ hrs	MS-DRG	871	27	—	$23,261	$15,431	$23,483	1.3×	$69,911
Septicemia or severe sepsis w/o MV 96+ hrs	MS-DRG	872	27	—	$12,598	$8,295.9	$12,371	1.2×	$42,298
lab
Basic metabolic panel (BMP)	CPT	80048	29	$464	$9.73	$5.92	$9.86	0.30×	$59.22
General health panel	CPT	80050	9	$864	—	$32.11	$78.56	0.73×	$321.09
Electrolyte panel	CPT	80051	29	$267	$8.06	$4.91	$8.13	0.34×	$49.07
Comprehensive metabolic panel	CPT	80053	29	$864	$12.14	$7.39	$12.3	0.28×	$73.92
Lipid panel	CPT	80061	29	$536	$15.4	$9.37	$15.53	0.41×	$93.73
Renal function panel	CPT	80069	29	$134	$9.98	$6.08	$10.07	0.37×	$60.76
Hepatic function panel	CPT	80076	29	$400	$9.4	$5.72	$9.52	0.36×	$57.19
Urinalysis non-automated	CPT	81002	29	$37	$4	$2.44	$4.04	0.58×	$24.36
Urinalysis automated	CPT	81003	29	$33	$2.59	$1.58	$2.61	0.19×	$15.75
Glucose quantitative	CPT	82947	29	$57	$4.52	$2.75	$4.58	0.26×	$27.51
Hemoglobin A1c	CPT	83036	29	$149	$11.17	$6.8	$10.68	0.40×	$67.97
Thyroid stimulating hormone (TSH)	CPT	84443	29	$423	$19.32	$11.76	$19.57	0.41×	$117.6
Complete blood count with automated differential	CPT	85025	29	$81	$8.94	$5.44	$8.74	0.33×	$54.39
Complete blood count without differential	CPT	85027	29	$64	$7.44	$4.53	$7.51	0.35×	$45.29
Urine culture bacterial	CPT	87086	29	$101	$9.28	$5.65	$9.36	0.40×	$56.49
Urine culture identification	CPT	87088	29	$101	$9.3	$5.66	$9.38	0.42×	$56.63
Tissue exam by pathologist level IV	CPT	88305	9	$384	$61.57	$11.7	$45.1	0.44×	$360.64
maternity
Fetal non-stress test	CPT	59025	6	$831	$238.86	$6.14	$23.21	0.12×	$353
Routine obstetric care including vaginal delivery	CPT	59400	4	—	—	$2,321.8	$3,716.04	1.6×	$5,792.04
Vaginal delivery only	CPT	59409	6	$8,482	$3,824.55	$794.32	$3,463.02	1.6×	$9,360
Vaginal delivery with postpartum	CPT	59410	4	—	—	$2,422	$3,777.43	3.6×	$5,750
Routine obstetric care with C-section	CPT	59510	4	—	—	$2,321.8	$3,716.04	1.5×	$5,792.04
C-section delivery only	CPT	59514	3	—	—	$3,348	$7,800	8.2×	$9,360
C-section with postpartum	CPT	59515	4	—	—	$2,665	$4,802.43	3.8×	$10,510
Cesarean section w CC/MCC	MS-DRG	765	2	—	—	$22,553	$29,925	331.8×	$42,025
Cesarean section w/o CC/MCC	MS-DRG	766	2	—	—	$15,315	$24,661	273.7×	$28,538
Vaginal delivery w complicating dx	MS-DRG	774	2	—	—	$13,986	$23,675	257.3×	$26,062
Vaginal delivery w/o complicating dx	MS-DRG	775	2	—	—	$10,116	$18,241	19.5×	$24,978
office
Office visit, new patient, 15-29 min	CPT	99202	4	$206	—	$39.67	$107.4	1.2×	$167.4
Office visit, new patient, 30-44 minutes	CPT	99203	4	$247.2	—	$52.32	$107.4	0.88×	$167.4
Office visit, new patient, 45-59 min	CPT	99204	4	$301	—	$71.73	$122.26	0.70×	$252.13
Office visit, new patient, 60-74 min	CPT	99205	4	$385	—	$78	$159.02	0.72×	$327.94
Office visit, established patient, 5 min	CPT	99211	4	$130	—	$29.58	$107.4	1.7×	$167.4
Office visit, established patient, 10-19 min	CPT	99212	4	$130	—	$39.67	$107.4	1.3×	$167.4
Office visit, established patient, 20-29 minutes	CPT	99213	4	$144	—	$39.67	$107.4	0.94×	$167.4
Office visit, established patient, 30-39 minutes	CPT	99214	4	$150	—	$52.32	$107.4	0.70×	$167.4
Office visit, established patient, 40-54 min	CPT	99215	4	$322	—	$71.73	$113.72	0.60×	$217.76
preventive
Upper GI endoscopy diagnostic	CPT	43235	8	$2,601	$1,071.57	$162.79	$1,343.43	1.5×	$6,300
Upper GI endoscopy with biopsy	CPT	43239	8	$2,759	$1,071.57	$193.15	$1,563	1.6×	$7,560
Sigmoidoscopy diagnostic	CPT	45330	8	$2,618	$1,098.72	$69.1	$1,414.58	1.7×	$6,300
Sigmoidoscopy with biopsy	CPT	45331	8	$3,740	$1,098.72	$82.77	$1,261.13	1.4×	$6,300
Colonoscopy diagnostic	CPT	45378	8	$2,843	$1,098.72	$99.28	$1,235.97	1.4×	$6,300
Colonoscopy with biopsy	CPT	45380	8	$3,411	$1,413.79	$293.05	$1,617.4	1.3×	$6,300
Colonoscopy with polyp removal	CPT	45385	8	$3,411	$1,413.79	$348.5	$1,892.6	1.6×	$8,609
surgery
Total shoulder arthroplasty	CPT	23472	5	—	—	$7,555.68	$11,615	2.8×	$24,614
PCI w drug-eluting stent w MCC	MS-DRG	246	4	—	—	$53,081	$64,518	2.3×	$117,378
PCI w drug-eluting stent w/o MCC	MS-DRG	247	4	—	—	$34,040	$41,375	2.3×	$72,505
Hip hemiarthroplasty	CPT	27125	5	—	—	$5,981.58	$9,518	7.6×	$13,703
Total hip replacement	CPT	27130	8	—	—	$1,008.8	$12,118	2.8×	$27,583
Total knee replacement	CPT	27447	8	—	—	$1,008.8	$12,118	2.9×	$27,583
Knee revision arthroplasty single component	CPT	27486	7	—	—	$1,008.8	$9,360	5.6×	$20,334
Knee revision arthroplasty all components	CPT	27487	5	—	—	$6,611.22	$9,732	4.9×	$20,334
Shoulder arthroscopy with decompression	CPT	29826	4	—	—	$5,332	$8,302	25.4×	$10,200
Shoulder arthroscopy with rotator cuff repair	CPT	29827	7	—	—	$1,008.8	$7,418.61	2.3×	$13,334
Knee arthroscopy with meniscectomy	CPT	29881	7	—	—	$706.55	$2,600.28	1.3×	$12,000
ACL reconstruction	CPT	29888	7	—	—	$1,008.8	$8,302	2.5×	$10,200
Major small/large bowel procedures w MCC	MS-DRG	329	27	—	$54,048	$35,585	$55,567	1.3×	$194,887
Major small/large bowel procedures w CC	MS-DRG	330	27	—	$28,536	$18,509	$28,980	1.2×	$94,725
Major small/large bowel procedures w/o CC/MCC	MS-DRG	331	27	—	$20,250	$13,047	$20,345	1.2×	$60,488
CABG single arterial graft	CPT	33533	3	—	—	$7,800	$8,803.5	4.7×	$9,534
CABG 2 arterial grafts	CPT	33534	3	—	—	$7,800	$8,803.5	4.1×	$9,534
CABG 3 arterial grafts	CPT	33535	3	—	—	$7,800	$8,803.5	3.9×	$9,534
CABG 4+ arterial grafts	CPT	33536	3	—	—	$7,800	$8,803.5	3.6×	$9,534
Laparoscopic cholecystectomy w/o CDE w MCC	MS-DRG	418	27	—	$20,351	$13,104	$20,450	1.2×	$62,012
Laparoscopic cholecystectomy w/o CDE w CC	MS-DRG	419	27	—	$16,572	$10,492	$16,511	1.2×	$42,977
Laparoscopic cholecystectomy w/o CDE w/o CC/MCC	MS-DRG	420	27	—	$40,251	$27,443	$41,189	1.3×	$156,157
Open appendectomy	CPT	44950	7	—	—	$1,008.8	$6,696.11	5.9×	$10,011
Laparoscopic appendectomy	CPT	44970	7	—	—	$1,008.8	$6,611.22	4.2×	$12,000
Spinal fusion (non-cervical) w MCC	MS-DRG	459	4	—	—	$108,912	$139,332	2.8×	$233,223
Spinal fusion (non-cervical) w/o MCC	MS-DRG	460	4	—	—	$66,257	$80,533	2.4×	$140,667
Major joint replacement w MCC	MS-DRG	469	27	—	$35,914	$25,444	$36,668	1.2×	$126,201
Major joint replacement w/o MCC	MS-DRG	470	27	—	$23,104	$14,844	$23,319	1.2×	$78,162
Laparoscopic cholecystectomy	CPT	47562	7	—	—	$1,008.8	$9,721.5	5.5×	$22,668
Lap cholecystectomy with cholangiography	CPT	47563	7	—	—	$1,008.8	$9,721.5	5.2×	$22,668
Hip & femur procedures except major joint w MCC	MS-DRG	480	27	—	$34,511	$22,933	$35,207	1.3×	$109,024
Hip & femur procedures except major joint w CC	MS-DRG	481	27	—	$25,025	$16,296	$25,320	1.2×	$69,668
Hip & femur procedures except major joint w/o CC/MCC	MS-DRG	482	27	—	$19,648	$12,552	$19,717	1.2×	$57,147
Lap inguinal hernia repair	CPT	49650	7	—	—	$1,010.09	$6,696.11	6.0×	$12,000
Total abdominal hysterectomy	CPT	58150	4	—	—	$7,800	$9,360	9.6×	$11,938
Vaginal hysterectomy	CPT	58260	7	—	—	$1,008.8	$8,814.96	4.9×	$18,668
Lap-assisted vaginal hysterectomy	CPT	58550	7	—	—	$1,008.8	$8,814.96	6.0×	$18,668
Lap-assisted vaginal hysterectomy >250g	CPT	58552	7	—	—	$1,008.8	$8,814.96	4.0×	$13,334
Lap salpingo-oophorectomy	CPT	58661	7	—	—	$1,008.8	$7,418.61	3.7×	$13,334
OR procedure for obesity w MCC	MS-DRG	619	27	—	$34,222	$21,289	$34,906	1.3×	$135,897
OR procedure for obesity w CC	MS-DRG	620	27	—	$19,292	$12,633	$19,346	1.2×	$69,232
OR procedure for obesity w/o CC/MCC	MS-DRG	621	27	—	$18,226	$11,597	$18,235	1.2×	$54,982
Complex cataract surgery	CPT	66982	7	—	—	$2,150.2	$8,814.96	4.0×	$18,002
Cataract surgery with lens implant	CPT	66984	7	—	—	$783.29	$4,614.66	2.1×	$18,002
Intravitreal injection	CPT	67028	7	$714	$390.24	$119.39	$897.93	2.6×	$5,750
Vitrectomy mechanical	CPT	67042	7	—	—	$1,008.8	$9,721.5	3.9×	$18,668
Uterine & adnexa procedures w CC/MCC	MS-DRG	743	27	—	$15,120	$9,581.07	$14,999	1.2×	$35,678
Uterine & adnexa procedures w/o CC/MCC	MS-DRG	744	27	—	$24,498	$15,369	$24,772	1.3×	$58,924
PCI single major coronary artery	CPT	92920	7	$15,951	$6,724.37	$1,008.8	$10,557	1.9×	$12,668
PCI with drug-eluting stent	CPT	92928	7	$15,923	$13,639	$1,008.8	$10,831	1.1×	$12,743
PCI bypass graft	CPT	92937	7	$35,986	$13,639	$1,008.8	$10,831	1.00×	$12,743
Left heart catheterization	CPT	93452	5	$7,172	$3,830.22	$1,008.8	$4,300	1.4×	$12,593
Coronary angiography with cath	CPT	93455	5	$14,252	$3,830.22	$1,008.8	$4,300	1.4×	$12,593
Coronary angiography with bypass cath	CPT	93458	5	$27,310	$3,830.22	$1,008.8	$4,300	1.4×	$12,593

Rate history available after the next quarterly refresh. We re-crawl all hospital MRFs each quarter to track rate changes over time.

Payer mix (top 30)

Payer	Codes covered	Median rate
Aetna	182	$1,627.75
ibc	167	$6,611.22
Cigna	160	$881.21
upmc commercial	160	$3,270
Medicaid	134	$143.2
Blue Cross Blue Shield	131	$11,645
pa health_wellness chc	131	$173.67
keystone first	130	$373.86
geisinger health plan	122	$1,314.49
UnitedHealthcare	118	$381.4
Medicare	111	$220.61
Medicare Advantage	109	$338.7
naphcare	109	$419.16
optum va ccn	109	$220.61
perennial	109	$255.91
point of comfort refugee resettlement	109	$220.61
provider partners health plan	109	$236.05
st agnes	109	$220.61
va_champus_tricare	109	$220.61
allwell pa health_wellness ma	109	$242.67
Ambetter	109	$319.89
devoted health participation	109	$231.64
Humana	109	$225.02
ibc employee benefit	109	$275.76
ibc main line health	109	$275.76
innovage	109	$220.61
inspira life	109	$220.61
jefferson health plan aca qhp exchange	109	$209.58
keystone first vip choice	109	$220.61
qualcare jcc	48	$37,043

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