# Heart valve surgery with catheterization (hospital stay): what Anthem Blue Cross and Blue Shield pays, by state

The whole hospital stay for major heart valve or chest surgery with catheterization, complicated cases.

- Insurer: Anthem Blue Cross and Blue Shield
- Billing code: 216 (Hospital stays (inpatient))
- Price shown: negotiated in-network price, hospital stay, facility fee
- Prices as of: unknown
- All of the insurer's plans pooled; the map also shows single networks

| State | Providers | Lowest | 25th pct | Median | 75th pct | Highest | Medicare pays | Median vs Medicare |
|---|---|---|---|---|---|---|---|---|
| Arkansas | 1 | $39,776.00 | $39,776.00 | $39,776.00 | $39,776.00 | $39,776.00 | $65,565.16 | 0.6x Medicare |
| California | 182 | $35,640.00 | $147,906.15 | $244,119.99 | $357,051.00 | $496,193.39 | $167,844.28 | 1.4x Medicare |
| Colorado | 154 | $77,548.25 | $207,150.79 | $230,874.08 | $256,514.79 | $1,125,256.78 |  |  |
| Connecticut | 70 | $79,835.96 | $196,849.50 | $219,079.46 | $263,668.05 | $311,259.34 | $114,098.32 | 1.9x Medicare |
| Georgia | 112 | $2,406.80 | $29,195.00 | $83,360.60 | $241,489.59 | $360,321.16 | $87,443.28 | about what Medicare pays |
| Illinois | 11 | $83,418.96 | $142,734.17 | $162,418.88 | $189,017.11 | $285,051.22 | $110,601.98 | 1.5x Medicare |
| Indiana | 143 | $1,500.00 | $148,718.12 | $175,963.22 | $215,427.03 | $283,887.07 | $71,969.56 | 2.4x Medicare |
| Kentucky | 145 | $39,776.00 | $96,027.96 | $134,220.01 | $154,049.75 | $276,011.91 | $75,329.46 | 1.8x Medicare |
| Maine | 68 | $164,246.65 | $220,065.74 | $228,041.56 | $292,150.70 | $292,150.70 | $93,535.31 | 2.4x Medicare |
| Massachusetts | 2 | $88,306.00 | $107,120.85 | $125,935.69 | $144,750.54 | $163,565.38 | $116,022.05 | 1.1x Medicare |
| Michigan | 1 | $153,541.04 | $153,541.04 | $153,541.04 | $153,541.04 | $153,541.04 | $114,620.85 | 1.3x Medicare |
| Minnesota | 5 | $107,610.80 | $107,610.80 | $163,656.46 | $163,656.46 | $163,656.46 | $111,449.14 | 1.5x Medicare |
| Missouri | 139 | $16,973.15 | $83,803.75 | $108,432.55 | $154,844.00 | $246,966.78 | $105,954.96 | about what Medicare pays |
| Nevada | 42 | $107,053.18 | $131,853.16 | $201,759.68 | $201,759.68 | $245,391.75 | $96,356.00 | 2.1x Medicare |
| New Hampshire | 30 | $92,271.00 | $131,076.01 | $159,233.00 | $195,610.41 | $315,045.29 | $127,155.24 | 1.2x Medicare |
| New Jersey | 2 | $262,981.22 | $262,981.22 | $295,856.32 | $328,731.42 | $328,731.42 | $110,716.55 | 2.7x Medicare |
| New York | 107 | $128,839.47 | $265,182.35 | $305,037.48 | $353,569.95 | $517,079.67 | $127,182.71 | 2.4x Medicare |
| North Carolina | 1 | $85,364.71 | $85,364.71 | $85,364.71 | $85,364.71 | $85,364.71 | $89,055.26 | about what Medicare pays |
| Ohio | 200 | $7,000.00 | $132,938.46 | $170,895.73 | $193,582.04 | $282,292.47 | $99,920.25 | 1.7x Medicare |
| Pennsylvania | 5 | $45,304.14 | $45,304.14 | $102,337.87 | $102,337.87 | $102,337.87 | $113,213.40 | 0.9x Medicare |
| Rhode Island | 2 | $135,736.35 | $135,736.35 | $135,736.35 | $135,736.35 | $135,736.35 |  |  |
| Tennessee | 7 | $88,309.33 | $130,686.17 | $147,786.21 | $158,119.39 | $217,119.46 | $83,272.56 | 1.8x Medicare |
| Virginia | 79 | $97,505.16 | $163,636.89 | $195,822.30 | $219,281.46 | $349,872.05 | $98,281.96 | 2.0x Medicare |
| Wisconsin | 155 | $58,696.80 | $150,310.27 | $176,393.66 | $215,642.26 | $381,206.36 | $116,475.63 | 1.5x Medicare |

**“x Medicare”** compares each price with what original Medicare actually paid hospitals in the same state for the same kind of stay in 2024, the newest year it has published: the average per stay, the patient’s share included, at hospitals with more than ten such stays. Medicare’s payment varies by hospital (wages, teaching, low-income patients), so this is a state average, not any one hospital’s rate. Insurers write their contracts as a share of Medicare, so 1.3x means the insurer pays 30% more than Medicare would; Medicare Advantage plans generally pay close to 1.0x.

Prices are what the insurer has agreed to pay, not what you will be billed. This is a statewide summary: prices vary far more between towns and between practices than these medians suggest, and "providers" counts everyone with a contracted price, not only those who perform the procedure.

Map: https://medicalpricetransparency.netlify.app/insurers/anthem/statemap_216_US.html  
About this insurer's data, and its other procedures: [index.md](index.md)