▸ Payer

epic health plan

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

Hospitals

Procedures

179

States

Rate rows

3,060

Median neg. rate

$420

Top procedures for epic 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
Upper GI endoscopy with biopsy	CPT	43239	2	$1,160.81
Laparoscopic appendectomy	CPT	44970	2	$7,737.45
Heart failure & shock w MCC	MS-DRG	291	2	$16,105
Heart failure & shock w CC	MS-DRG	292	2	$10,944
Heart failure & shock w/o CC/MCC	MS-DRG	293	2	$7,584.96
Esophagitis/gastroenteritis w/o MCC	MS-DRG	392	2	$10,120
Cardiac arrhythmia w MCC	MS-DRG	308	2	$15,158
Cardiac arrhythmia w CC	MS-DRG	309	2	$9,599.2
Cardiac arrhythmia w/o CC/MCC	MS-DRG	310	2	$7,586.15
AMI discharged alive w MCC	MS-DRG	280	2	$19,907
AMI discharged alive w CC	MS-DRG	281	2	$11,776
AMI discharged alive w/o CC/MCC	MS-DRG	282	2	$9,449.64
Intracranial hemorrhage/CVA w MCC	MS-DRG	064	2	$24,736
Intracranial hemorrhage/CVA w CC	MS-DRG	065	2	$12,859
Intracranial hemorrhage/CVA w/o CC/MCC	MS-DRG	066	2	$8,990.3
Simple pneumonia & pleurisy w CC	MS-DRG	194	2	$10,432
Simple pneumonia & pleurisy w/o CC/MCC	MS-DRG	195	2	$8,326.8
Respiratory infections & inflammations w MCC	MS-DRG	177	2	$19,415
COPD w MCC	MS-DRG	190	2	$14,015
COPD w CC	MS-DRG	191	2	$10,873
COPD w/o CC/MCC	MS-DRG	192	2	$8,487.04
GI hemorrhage w CC	MS-DRG	378	2	$12,507
GI hemorrhage w/o CC/MCC	MS-DRG	379	2	$8,349.35
Major small/large bowel procedures w MCC	MS-DRG	329	2	$55,425
Major small/large bowel procedures w CC	MS-DRG	330	2	$29,320
Major small/large bowel procedures w/o CC/MCC	MS-DRG	331	2	$20,842
Laparoscopic cholecystectomy w/o CDE w MCC	MS-DRG	418	2	$20,945
Laparoscopic cholecystectomy w/o CDE w CC	MS-DRG	419	2	$17,078
Laparoscopic cholecystectomy w/o CDE w/o CC/MCC	MS-DRG	420	2	$41,307

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Lowest average negotiated rate across all procedures at this payer.

Hospital	City	ST	Avg neg. rate
Montclair Hospital Medical Center	Montclair	CA	$9,104
Chino Valley Medical Center	Chino	CA	$9,738.16

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States with hospitals publishing rates for epic health plan.

State	Hospitals	Avg rate
CA	2	$9,426.19

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