# Heart valve surgery with catheterization (hospital stay): what Medica pays, by state

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

- Insurer: Medica
- Billing code: 216 (Hospital stays (inpatient))
- Price shown: negotiated in-network price, hospital stay, facility fee
- Prices as of: 2026-10-01
- 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 | $2,148.00 | $2,148.00 | $2,148.00 | $2,148.00 | $2,148.00 | $65,565.16 | 0.0x Medicare |
| Illinois | 9 | $4,800.00 | $67,963.56 | $73,873.44 | $119,924.31 | $142,692.70 | $110,601.98 | 0.7x Medicare |
| Iowa | 14 | $5,944.00 | $11,838.00 | $12,761.00 | $14,824.00 | $23,642.00 | $69,398.45 | 0.2x Medicare |
| Kansas | 9 | $1,281.00 | $1,281.00 | $1,281.00 | $5,747.00 | $10,376.00 | $80,689.96 | 0.0x Medicare |
| Minnesota | 27 | $7,222.00 | $13,151.26 | $15,266.05 | $18,254.60 | $24,690.17 | $111,449.14 | 0.1x Medicare |
| Missouri | 30 | $5,390.00 | $8,934.00 | $11,168.00 | $11,948.00 | $87,653.89 | $105,954.96 | 0.1x Medicare |
| Nebraska | 16 | $10,511.47 | $14,891.50 | $17,226.00 | $20,239.00 | $23,487.00 | $91,869.50 | 0.2x Medicare |
| North Dakota | 4 | $6,025.42 | $12,604.37 | $13,224.00 | $14,004.85 | $15,816.00 |  |  |
| Oklahoma | 27 | $2,419.00 | $5,982.00 | $8,550.18 | $8,550.18 | $11,272.00 | $63,737.00 | 0.1x Medicare |
| South Dakota | 1 | $14,323.00 | $14,323.00 | $14,323.00 | $14,323.00 | $14,323.00 |  |  |
| Wisconsin | 56 | $9,978.00 | $139,127.26 | $141,850.60 | $162,553.45 | $205,083.20 | $116,475.63 | 1.2x 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/medica/statemap_216_US.html  
About this insurer's data, and its other procedures: [index.md](index.md)