Ambetter
What does Ambetter actually pay hospitals? We analyzed 101 negotiated rates from 1 hospitals across 1 states.
Is Ambetter Expensive or Cheap?
Based on our analysis of 101 negotiated rates, Ambetter is significantly more expensive than average compared to other insurance companies in our database. They pay roughly the same or less than Medicare for equivalent services.
Top Procedures with Negotiated Rates
Procedures where Ambetter has the most rate data
| Code | Description | Rates | Avg Rate | Min | Max |
|---|---|---|---|---|---|
| 85025 | CBC W/DIFFERENTIAL | 1 | $11 | $11 | $11 |
| 36415 | VENIPUNCTURE | 1 | $13 | $13 | $13 |
| 80053 | COMPREHENSIVE METABOLIC PROFIL | 1 | $15 | $15 | $15 |
| 71045 | CHEST XRAY 1 VIEW | 1 | $128 | $128 | $128 |
| 71046 | CHEST X-RAY 2 VIEWS | 1 | $128 | $128 | $128 |
| 73030 | SHOULDER RIGHT 2 VIEW | 1 | $128 | $128 | $128 |
| 73060 | HUMERUS X-RAY | 1 | $128 | $128 | $128 |
| 73562 | KNEE W/PATELLA | 1 | $128 | $128 | $128 |
| 73590 | TIBIA/FIBULA | 1 | $128 | $128 | $128 |
| 99281 | LEVEL 1 EMERGENCY EXAM | 1 | $128 | $128 | $128 |
| 70450 | CT-HEAD/BRAIN W/O CONTRAST | 1 | $154 | $154 | $154 |
| 71250 | CT-CHEST WITHOUT CONTRAST | 1 | $154 | $154 | $154 |
| 72100 | SPINE X-RAY LUMBAR 3 VIEWS | 1 | $154 | $154 | $154 |
| 72110 | SPINE LUMBAR W/OBLIQUES | 1 | $154 | $154 | $154 |
| 72125 | CT-CERVICAL SPINE W/O CONTRAST | 1 | $154 | $154 | $154 |
| 72131 | CT LUMBAR SPINE W/O CONTRAST | 1 | $154 | $154 | $154 |
| 99282 | LEVEL II EMERGENCY EXAM | 1 | $230 | $230 | $230 |
| 70460 | CT-HEAD WITH CONTRAST | 1 | $259 | $259 | $259 |
| 71260 | CT-CHEST WITH CONTRAST | 1 | $259 | $259 | $259 |
| 72133 | CT-SPINE LUMBAR W/WO | 1 | $259 | $259 | $259 |
| 12001 | SIMP RP SCALPNECKAXILLAETRU | 1 | $289 | $289 | $289 |
| 12002 | RPR S/N/AX/GEN/TRNK2.6-7.5CM | 1 | $289 | $289 | $289 |
| 12004 | RPR S/N/AX/GEN/TRK7.6-12.5CM | 1 | $289 | $289 | $289 |
| 12011 | RPR F/E/E/N/L/M 2.5 CM/< | 1 | $289 | $289 | $289 |
| 25600 | TREAT FRACTURE RADIUS/ULNA | 1 | $348 | $348 | $348 |
Hospitals with Ambetter Rates
Hospitals where we have negotiated rate data for Ambetter
| Hospital | State | Rates | Procedures | Avg Rate | Range |
|---|---|---|---|---|---|
| CHI St. Luke's Health Brazosport | TX | 101 | 101 | $14,559 | $11 - $292,108 |
About This Data
These rates are from hospital Machine-Readable Files (MRFs) required by the CMS Hospital Price Transparency Rule. They reflect specific hospital-payer contracts and may not represent your actual cost, which depends on your specific plan, deductible, copay, coinsurance, and network status. Data sources include CommonSpirit Health, HCA Healthcare, and Kaiser Permanente filings.