Insurance Company Report Card
What do insurance companies actually pay hospitals? We analyzed 39,756 negotiated rates from 144 payers to find out.
Data source: Hospital Machine-Readable Files (MRFs) required by the CMS Hospital Price Transparency Rule. This data was previously hidden from the public.
144
Insurance Companies
39,756
Negotiated Rates
$10,146
Overall Avg Rate
$15,331
Avg Medicare Payment
What Major Insurers Pay vs. Medicare
Medicare pays hospitals an average of $15,331 per service. Here's how private insurers compare:
Aetna
$5,324
0.3x Medicare
United
$9,252
0.6x Medicare
Cigna
$11,047
0.7x Medicare
Humana
$11,602
0.8x Medicare
BCBS
$13,187
0.9x Medicare
Superior Health Plan
$13,042
0.9x Medicare
BCBS-TX
$4,918
0.3x Medicare
Multiplan
$12,676
0.8x Medicare
KAISER FOUNDATION HEALTH PLAN, INC.
$4,288
0.3x Medicare
Bright Health
$19,654
1.3x Medicare
Anthem
$14,817
1x Medicare
Wellpoint
$6,416
0.4x Medicare
Kaiser
$6,843
0.4x Medicare
CHC
$1,670
0.1x Medicare
BCBS - TN
$8,465
0.6x Medicare
Medicare baseline: $15,331 avg payment
Lowest Average Rates
Insurance companies with the lowest negotiated rates
1
Peach State
216 rates from 2 hospitals
$729
0x Medicare
2
Community Health Choice MCD
356 rates from 3 hospitals
$789
0.1x Medicare
3
Seasons Hospice
126 rates from 2 hospitals
$800
0.1x Medicare
4
Aetna Better Health
106 rates from 3 hospitals
$877
0.1x Medicare
5
TCHP
320 rates from 2 hospitals
$932
0.1x Medicare
Highest Average Rates
Insurance companies with the highest negotiated rates
1
HSTechnology
68 rates from 2 hospitals
$42,588
2.8x Medicare
2
NX Health
101 rates from 1 hospitals
$32,974
2.2x Medicare
3
Molina
79 rates from 3 hospitals
$30,109
2x Medicare
4
Superior
219 rates from 3 hospitals
$26,074
1.7x Medicare
5
Entrust
101 rates from 1 hospitals
$25,746
1.7x Medicare
All Insurance Companies
Complete report card for all 100 payers with sufficient data
| Insurer | Rates | Procedures | Hospitals | Avg Rate | Min Rate | Max Rate | vs Medicare |
|---|---|---|---|---|---|---|---|
| Aetna | 5,542 | 135 | 11 | $5,324 | $8 | $378,295 | 0.3x |
| United | 3,442 | 123 | 10 | $9,252 | $2 | $560,173 | 0.6x |
| Cigna | 2,926 | 145 | 10 | $11,047 | $0 | $663,392 | 0.7x |
| Humana | 2,301 | 134 | 11 | $11,602 | $8 | $411,111 | 0.8x |
| BCBS | 1,653 | 120 | 5 | $13,187 | $7 | $307,828 | 0.9x |
| Superior Health Plan | 1,045 | 112 | 4 | $13,042 | $8 | $311,876 | 0.9x |
| BCBS-TX | 969 | 97 | 3 | $4,918 | $11 | $279,273 | 0.3x |
| Multiplan | 936 | 121 | 6 | $12,676 | $22 | $418,329 | 0.8x |
| KAISER FOUNDATION HEALTH PLAN, INC. | 930 | 66 | 5 | $4,288 | $8 | $69,590 | 0.3x |
| Bright Health | 768 | 127 | 5 | $19,654 | $5 | $319,318 | 1.3x |
| Anthem | 754 | 116 | 2 | $14,817 | $7 | $768,976 | 1x |
| Wellpoint | 689 | 109 | 2 | $6,416 | $7 | $311,876 | 0.4x |
| Kaiser | 652 | 67 | 2 | $6,843 | $8 | $240,239 | 0.4x |
| CHC | 613 | 77 | 2 | $1,670 | $7 | $11,539 | 0.1x |
| BCBS - TN | 574 | 123 | 2 | $8,465 | $6 | $279,158 | 0.6x |
| UNITED | 485 | 102 | 2 | $2,910 | $7 | $201,454 | 0.2x |
| Cigna HealthSpring | 478 | 44 | 5 | $23,027 | $8 | $244,622 | 1.5x |
| WellCare | 478 | 44 | 5 | $23,585 | $8 | $242,594 | 1.5x |
| Molina Healthcare | 457 | 89 | 3 | $7,921 | $7 | $412,960 | 0.5x |
| Amerigroup | 445 | 125 | 3 | $8,320 | $8 | $196,947 | 0.5x |
| Provider Partners Health Plan of Texas | 395 | 42 | 3 | $23,578 | $8 | $214,284 | 1.5x |
| BCBS - GA | 394 | 109 | 1 | $7,496 | $8 | $189,585 | 0.5x |
| BCBS - Anthem | 384 | 117 | 1 | $8,193 | $5 | $220,086 | 0.5x |
| Community Health Choice | 382 | 108 | 5 | $17,797 | $8 | $311,876 | 1.2x |
| Community Health Choice MCD | 356 | 51 | 3 | $789 | $7 | $7,897 | 0.1x |
| TCHP | 320 | 64 | 2 | $932 | $7 | $9,940 | 0.1x |
| HUMANA | 303 | 101 | 2 | $10,111 | $8 | $207,918 | 0.7x |
| Wellcare | 278 | 120 | 2 | $7,037 | $8 | $218,991 | 0.5x |
| Oscar | 220 | 75 | 3 | $15,147 | $8 | $205,880 | 1x |
| Superior | 219 | 39 | 3 | $26,074 | $11 | $255,087 | 1.7x |
| Pinnacol Workers Comp | 217 | 117 | 2 | $14,682 | $21 | $324,228 | 1x |
| Employers Health Network | 216 | 108 | 2 | $11,889 | $5 | $286,107 | 0.8x |
| Peach State | 216 | 72 | 2 | $729 | $9 | $5,446 | 0x |
| Rocky Mountain Health Plan | 211 | 106 | 2 | $11,405 | $3 | $560,173 | 0.7x |
| Passport by Molina | 206 | 117 | 1 | $9,608 | $8 | $229,941 | 0.6x |
| Centene | 205 | 104 | 2 | $14,855 | $13 | $314,748 | 1x |
| Healthsmart | 204 | 106 | 1 | $7,177 | $39 | $228,163 | 0.5x |
| OPTUM | 204 | 68 | 1 | $2,566 | $15 | $17,334 | 0.2x |
| CIGNA HEALTHSPRING | 202 | 101 | 1 | $10,197 | $8 | $209,997 | 0.7x |
| SCANHealth | 202 | 101 | 2 | $10,800 | $8 | $222,472 | 0.7x |
| SELECTCARE | 202 | 101 | 2 | $10,244 | $8 | $207,918 | 0.7x |
| KELSEY | 200 | 101 | 2 | $9,774 | $3 | $201,454 | 0.6x |
| UHC | 192 | 64 | 1 | $964 | $7 | $22,000 | 0.1x |
| KelseyCare | 178 | 108 | 1 | $8,666 | $10 | $280,689 | 0.6x |
| CareSource | 173 | 120 | 2 | $12,051 | $11 | $437,983 | 0.8x |
| Devoted Health | 169 | 46 | 5 | $23,078 | $8 | $240,239 | 1.5x |
| Healthcare Highways | 166 | 75 | 3 | $21,330 | $7 | $340,967 | 1.4x |
| Curative Administrators | 148 | 70 | 3 | $17,097 | $575 | $289,682 | 1.1x |
| Coventry | 140 | 68 | 2 | $3,341 | $36 | $13,637 | 0.2x |
| First Health | 136 | 68 | 1 | $3,431 | $36 | $13,637 | 0.2x |
| Interlink | 136 | 68 | 1 | $3,695 | $39 | $14,686 | 0.2x |
| MHealth Network | 136 | 68 | 1 | $5,279 | $56 | $20,980 | 0.3x |
| MultiPlan | 136 | 68 | 1 | $3,959 | $42 | $15,735 | 0.3x |
| TCHPCHIP | 136 | 68 | 1 | $2,047 | $20 | $9,021 | 0.1x |
| TEXASTRUECHOICE | 136 | 68 | 1 | $2,904 | $31 | $11,539 | 0.2x |
| USA Health Network | 136 | 68 | 1 | $4,487 | $48 | $17,833 | 0.3x |
| Humana National Transplant Network | 132 | 44 | 1 | $22,069 | $8 | $232,973 | 1.4x |
| Alliant Health | 130 | 65 | 2 | $1,093 | $1 | $6,095 | 0.1x |
| Health First | 130 | 65 | 1 | $2,887 | $30 | $10,906 | 0.2x |
| Health One Alliance | 128 | 64 | 2 | $2,643 | $179 | $8,182 | 0.2x |
| Seasons Hospice | 126 | 34 | 2 | $800 | $800 | $800 | 0.1x |
| Evry Health | 119 | 60 | 3 | $22,119 | $505 | $296,707 | 1.4x |
| Physician Health Partners | 114 | 76 | 2 | $2,788 | $36 | $22,229 | 0.2x |
| TriWest Health Alliance | 111 | 52 | 5 | $17,084 | $8 | $235,529 | 1.1x |
| Western Plains Community Health | 109 | 76 | 2 | $2,323 | $34 | $20,641 | 0.2x |
| Colorado Program for Children with Special Needs | 107 | 74 | 2 | $1,309 | $22 | $7,609 | 0.1x |
| Aetna Better Health | 106 | 50 | 3 | $877 | $7 | $8,902 | 0.1x |
| BCBS - ND | 104 | 104 | 1 | $8,453 | $8 | $187,933 | 0.6x |
| AETNA | 101 | 101 | 1 | $10,349 | $8 | $212,076 | 0.7x |
| Ambetter | 101 | 101 | 1 | $14,559 | $11 | $292,108 | 0.9x |
| Amerivantage | 101 | 101 | 1 | $10,450 | $8 | $214,155 | 0.7x |
| CIGNA-HEALTHSPRING | 101 | 101 | 1 | $10,040 | $8 | $201,454 | 0.7x |
| DEVOTED | 101 | 101 | 1 | $10,856 | $8 | $222,472 | 0.7x |
| Devoted | 101 | 101 | 1 | $10,743 | $8 | $215,555 | 0.7x |
| Entrust | 101 | 101 | 1 | $25,746 | $8 | $523,780 | 1.7x |
| KINDRED | 101 | 101 | 1 | $11,160 | $9 | $228,709 | 0.7x |
| NX Health | 101 | 101 | 1 | $32,974 | $25 | $675,732 | 2.2x |
| Renaissance | 101 | 101 | 1 | $7,305 | $6 | $149,701 | 0.5x |
| UHC-SecureHorizons | 101 | 101 | 1 | $10,349 | $8 | $212,076 | 0.7x |
| WellcareTP | 101 | 101 | 1 | $10,342 | $8 | $207,497 | 0.7x |
| American Health Plan | 100 | 45 | 3 | $14,089 | $8 | $220,586 | 0.9x |
| ProCare Advantage | 99 | 45 | 3 | $16,318 | $8 | $220,586 | 1.1x |
| Mutual of Omaha | 93 | 49 | 2 | $21,243 | $8 | $244,622 | 1.4x |
| Shared Health | 85 | 46 | 3 | $24,406 | $8 | $224,788 | 1.6x |
| Anthem BCBS | 83 | 44 | 2 | $22,789 | $8 | $235,529 | 1.5x |
| Delaware Life Insurance | 83 | 44 | 2 | $23,378 | $8 | $242,594 | 1.5x |
| Rocky Mountain Health | 83 | 44 | 2 | $22,697 | $8 | $235,529 | 1.5x |
| Total LongTerm Care | 83 | 44 | 2 | $22,789 | $8 | $235,529 | 1.5x |
| Verda Health Plan | 82 | 44 | 3 | $25,322 | $10 | $231,090 | 1.7x |
| Integranet Amerigroup IPA | 79 | 42 | 3 | $23,304 | $8 | $214,284 | 1.5x |
| Molina | 79 | 42 | 3 | $30,109 | $8 | $367,644 | 2x |
| TriWest Healthcare Alliance | 79 | 42 | 3 | $23,115 | $8 | $210,082 | 1.5x |
| Van Lang IPA | 79 | 42 | 3 | $23,448 | $8 | $212,183 | 1.5x |
| WellMed | 75 | 40 | 3 | $16,446 | $8 | $162,927 | 1.1x |
| Aetna-Kelsey Care | 72 | 71 | 2 | $3,379 | $158 | $12,378 | 0.2x |
| Fidelis SecureCare of TX | 72 | 72 | 1 | $15,842 | $171 | $236,103 | 1x |
| HealthSmart Preferred Care | 72 | 24 | 1 | $5,012 | $163 | $24,180 | 0.3x |
| Coventry National First Health | 71 | 57 | 2 | $2,921 | $203 | $15,162 | 0.2x |
| Cigna Lifesource | 68 | 68 | 1 | $3,168 | $34 | $12,588 | 0.2x |
| HSTechnology | 68 | 34 | 2 | $42,588 | $6,688 | $343,339 | 2.8x |
Understanding Insurance Rates
What are negotiated rates?
These are the actual prices that insurance companies have contracted with hospitals to pay for specific services. Since January 2021, hospitals are required to publish these rates in machine-readable files.
Why do rates vary so much?
Each insurer negotiates separately with each hospital. Larger insurers can often negotiate lower rates. The same procedure can cost 10x more at one hospital vs. another, even with the same insurer.
Is this what I would pay?
Not necessarily. Your out-of-pocket cost depends on your deductible, copay, coinsurance, and out-of-pocket maximum. These rates show what your insurer pays the hospital on your behalf.
Why compare to Medicare?
Medicare rates are set by the government and are the closest thing to a "standard price" in US healthcare. Comparing to Medicare shows how much more or less private insurers pay.