▸ Payer

elite health plan

Negotiated rates published by hospitals for elite health plan across 1 states. Data sourced from federally-mandated machine-readable files.

Hospitals

Procedures

152

States

Rate rows

290

Median neg. rate

$446.5

Top procedures for elite health plan

By number of hospitals reporting rates for this payer.

Procedure	Type	Code	Hospitals	Avg rate
Upper GI endoscopy diagnostic	CPT	43235	2	$1,160.81
Sigmoidoscopy diagnostic	CPT	45330	2	$1,190.22
Major joint replacement w MCC	MS-DRG	469	2	$29,344
Heart failure & shock w MCC	MS-DRG	291	2	$12,660
Heart failure & shock w CC	MS-DRG	292	2	$8,513.61
Heart failure & shock w/o CC/MCC	MS-DRG	293	2	$5,814.7
Esophagitis/gastroenteritis w/o MCC	MS-DRG	392	2	$7,851.76
Cardiac arrhythmia w MCC	MS-DRG	308	2	$11,899
Cardiac arrhythmia w CC	MS-DRG	309	2	$7,433.09
Cardiac arrhythmia w/o CC/MCC	MS-DRG	310	2	$5,815.65
AMI discharged alive w MCC	MS-DRG	280	2	$15,715
AMI discharged alive w CC	MS-DRG	281	2	$9,182.14
AMI discharged alive w/o CC/MCC	MS-DRG	282	2	$7,312.93
Intracranial hemorrhage/CVA w MCC	MS-DRG	064	2	$19,595
Intracranial hemorrhage/CVA w CC	MS-DRG	065	2	$10,052
Intracranial hemorrhage/CVA w/o CC/MCC	MS-DRG	066	2	$6,943.85
Simple pneumonia & pleurisy w CC	MS-DRG	194	2	$8,102.57
Simple pneumonia & pleurisy w/o CC/MCC	MS-DRG	195	2	$6,410.75
Respiratory infections & inflammations w MCC	MS-DRG	177	2	$15,320
COPD w MCC	MS-DRG	190	2	$10,981
COPD w CC	MS-DRG	191	2	$8,456.39
COPD w/o CC/MCC	MS-DRG	192	2	$6,539.49
GI hemorrhage w CC	MS-DRG	378	2	$9,769.61
GI hemorrhage w/o CC/MCC	MS-DRG	379	2	$6,428.87
Major small/large bowel procedures w MCC	MS-DRG	329	2	$44,253
Major small/large bowel procedures w CC	MS-DRG	330	2	$23,279
Major small/large bowel procedures w/o CC/MCC	MS-DRG	331	2	$16,466
Laparoscopic cholecystectomy w/o CDE w MCC	MS-DRG	418	2	$16,549
Laparoscopic cholecystectomy w/o CDE w CC	MS-DRG	419	2	$13,442
Laparoscopic cholecystectomy w/o CDE w/o CC/MCC	MS-DRG	420	2	$32,910

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Lowest average negotiated rate across all procedures at this payer.

Hospital	City	ST	Avg neg. rate
Sherman Oaks Hospital-Hlth	Sherman Oaks	CA	$5,081.59
Montclair Hospital Medical Center	Montclair	CA	$5,458.11

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States with hospitals publishing rates for elite health plan.

State	Hospitals	Avg rate
CA	2	$5,263.36

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