▸ Payer

emblemhealth

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

Hospitals

Procedures

198

States

Rate rows

591

Median neg. rate

$398.53

Top procedures for emblemhealth

By number of hospitals reporting rates for this payer.

Procedure	Type	Code	Hospitals	Avg rate
Knee arthroscopy with meniscectomy	CPT	29881	2	$2,911.61
Total hip replacement	CPT	27130	2	$10,934
Total knee replacement	CPT	27447	2	$10,933
Total shoulder arthroplasty	CPT	23472	2	$15,355
Shoulder arthroscopy with rotator cuff repair	CPT	29827	2	$6,315.52
ACL reconstruction	CPT	29888	2	$6,249.8
Heart failure & shock w MCC	MS-DRG	291	2	$23,319
Heart failure & shock w CC	MS-DRG	292	2	$15,435
Heart failure & shock w/o CC/MCC	MS-DRG	293	2	$9,882.12
Esophagitis/gastroenteritis w/o MCC	MS-DRG	392	2	$14,000
Cardiac arrhythmia w MCC	MS-DRG	308	2	$21,643
Cardiac arrhythmia w CC	MS-DRG	309	2	$13,278
Cardiac arrhythmia w/o CC/MCC	MS-DRG	310	2	$10,066
AMI discharged alive w MCC	MS-DRG	280	2	$29,363
AMI discharged alive w CC	MS-DRG	281	2	$16,511
AMI discharged alive w/o CC/MCC	MS-DRG	282	2	$13,067
Intracranial hemorrhage/CVA w MCC	MS-DRG	064	2	$35,594
Intracranial hemorrhage/CVA w CC	MS-DRG	065	2	$18,259
Intracranial hemorrhage/CVA w/o CC/MCC	MS-DRG	066	2	$12,377
Simple pneumonia & pleurisy w CC	MS-DRG	194	2	$14,711
Simple pneumonia & pleurisy w/o CC/MCC	MS-DRG	195	2	$11,162
Respiratory infections & inflammations w MCC	MS-DRG	177	2	$28,968
COPD w MCC	MS-DRG	190	2	$20,092
COPD w CC	MS-DRG	191	2	$15,419
COPD w/o CC/MCC	MS-DRG	192	2	$11,655
GI hemorrhage w CC	MS-DRG	378	2	$17,715
GI hemorrhage w/o CC/MCC	MS-DRG	379	2	$11,472
Major small/large bowel procedures w MCC	MS-DRG	329	2	$82,034
Major small/large bowel procedures w CC	MS-DRG	330	2	$42,235
Major small/large bowel procedures w/o CC/MCC	MS-DRG	331	2	$29,538

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Lowest average negotiated rate across all procedures at this payer.

Hospital	City	ST	Avg neg. rate
Nassau University Medical Center	East Meadow	NY	$2,484.84
University Hospital S U N Y Health Science Ctr T C	—	—	$24,644

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States with hospitals publishing rates for emblemhealth.

State	Hospitals	Avg rate
NY	1	$2,484.84

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