Heart valve surgery with catheterization (hospital stay)

The whole hospital stay for major heart valve or chest surgery with catheterization, complicated cases.
Code 216 · Hospital stays (inpatient) · statewide summary · negotiated in-network prices
Payers shown: UnitedHealthcare
Prices shown: hospital inpatient care
Doctor’s fee or facility fee? These are doctors' (professional) fees only. If this is done in a hospital or surgery center, the facility bills its own fee on top — for the room, nurses and equipment — often larger than the doctor's. That fee is not included here.
Who is counted: UnitedHealthcare lists clinicians individually: 89% of the 2,030,154 provider IDs (NPIs) it names are individual doctors, nurse practitioners and therapists; the rest are practices, clinics and hospitals. “Providers” counts those IDs.
Not on this map: Prices found in only some copies of a network: these files repeat themselves heavily, so each group of nearly identical files was read once, through one of its files. Checks on the largest groups found their files share 98-100% of their prices; the rest, typically 1-2%, is not shown. UMR: plans that UnitedHealthcare's administrator UMR runs for self-funded employers are published by UMR and shown on UMR's own page. Hospital stays: UnitedHealthcare's files price whole hospital stays for only a handful of hospitals, so its hospital-stay maps show very few places.
StateProvidersOrganisationsZip codes Lowest25th pctMedian75th pctHighestvs 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.
This is a statewide summary. Prices vary far more between towns and between practices than these medians suggest; zip-code and provider-level detail is not published here; this specific data can be requested here.