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

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

- Insurer: Highmark Blue Cross Blue Shield (Pennsylvania, Delaware, West Virginia, New York)
- Billing code: 216 (Hospital stays (inpatient))
- Price shown: negotiated in-network price, hospital stay, facility fee
- Prices as of: 2026-09-21
- 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 |
|---|---|---|---|---|---|---|---|---|
| Delaware | 1 | $227,607.27 | $227,607.27 | $227,607.27 | $227,607.27 | $227,607.27 |  |  |
| Pennsylvania | 12 | $50,766.76 | $133,776.13 | $165,723.52 | $190,534.35 | $287,080.39 | $113,213.40 | 1.5x Medicare |
| West Virginia | 2 | $194,024.74 | $213,992.43 | $233,960.11 | $253,927.80 | $273,895.48 | $88,552.29 | 2.6x 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/highmark/statemap_216_US.html  
About this insurer's data, and its other procedures: [index.md](index.md)