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

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

- Insurer: UPMC Health Plan
- Billing code: 216 (Hospital stays (inpatient))
- Price shown: negotiated in-network price, hospital stay, facility fee
- Prices as of: 2026-09-01
- 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 |
|---|---|---|---|---|---|---|---|---|
| Alabama | 5 | $69,068.54 | $69,068.54 | $69,246.88 | $83,869.04 | $180,931.52 | $85,746.00 | 0.8x Medicare |
| Alaska | 1 | $180,931.52 | $180,931.52 | $180,931.52 | $180,931.52 | $180,931.52 |  |  |
| Arizona | 11 | $55,630.61 | $69,068.54 | $69,068.54 | $78,435.27 | $180,931.52 | $92,752.44 | 0.7x Medicare |
| California | 34 | $69,068.54 | $69,068.54 | $69,246.88 | $83,869.04 | $180,931.52 | $167,844.28 | 0.4x Medicare |
| Colorado | 9 | $55,630.61 | $69,068.54 | $69,068.54 | $77,380.83 | $104,857.53 |  |  |
| Connecticut | 11 | $69,068.54 | $72,938.99 | $80,107.53 | $144,453.22 | $178,950.11 | $114,098.32 | 0.7x Medicare |
| Delaware | 9 | $69,068.54 | $80,226.98 | $83,869.04 | $84,592.69 | $178,950.11 |  |  |
| District of Columbia | 2 | $69,068.54 | $74,588.04 | $80,107.53 | $128,098.97 | $176,090.40 | $117,706.94 | 0.7x Medicare |
| Florida | 148 | $67,214.68 | $73,378.98 | $75,226.78 | $76,798.75 | $180,931.52 | $85,600.28 | 0.9x Medicare |
| Georgia | 12 | $67,214.68 | $69,068.54 | $69,068.54 | $80,997.75 | $180,931.52 | $87,443.28 | 0.8x Medicare |
| Hawaii | 2 | $69,068.54 | $72,768.66 | $76,468.79 | $80,168.91 | $83,869.04 |  |  |
| Idaho | 1 | $121,023.61 | $121,023.61 | $121,023.61 | $121,023.61 | $121,023.61 |  |  |
| Illinois | 24 | $67,214.68 | $69,068.54 | $69,068.54 | $76,798.75 | $180,931.52 | $110,601.98 | 0.6x Medicare |
| Indiana | 15 | $69,068.54 | $69,068.54 | $69,865.97 | $93,508.29 | $144,453.22 | $71,969.56 | about what Medicare pays |
| Iowa | 7 | $67,214.68 | $69,068.54 | $69,068.54 | $84,914.70 | $176,090.40 | $69,398.45 | about what Medicare pays |
| Kansas | 2 | $69,068.54 | $88,704.18 | $108,339.82 | $127,975.46 | $147,611.10 | $80,689.96 | 1.3x Medicare |
| Kentucky | 10 | $69,068.54 | $69,068.54 | $77,563.61 | $106,559.93 | $180,931.52 | $75,329.46 | about what Medicare pays |
| Louisiana | 5 | $69,068.54 | $69,068.54 | $69,068.54 | $83,869.04 | $94,299.44 |  |  |
| Maine | 6 | $69,068.54 | $78,500.62 | $80,266.79 | $85,890.24 | $178,950.11 | $93,535.31 | 0.9x Medicare |
| Maryland | 30 | $67,214.68 | $69,068.54 | $78,123.51 | $102,823.49 | $180,931.52 | $151,868.20 | 0.5x Medicare |
| Massachusetts | 27 | $55,630.61 | $69,068.54 | $69,068.54 | $76,798.75 | $180,931.52 | $116,022.05 | 0.6x Medicare |
| Michigan | 35 | $55,630.61 | $69,068.54 | $69,068.54 | $69,246.88 | $83,869.04 | $114,620.85 | 0.6x Medicare |
| Minnesota | 28 | $69,068.54 | $69,068.54 | $69,068.54 | $80,037.41 | $180,931.52 | $111,449.14 | 0.6x Medicare |
| Mississippi | 1 | $84,914.70 | $90,421.21 | $95,927.72 | $101,434.23 | $106,940.74 |  |  |
| Missouri | 8 | $69,068.54 | $69,068.54 | $69,068.54 | $69,068.54 | $83,869.04 | $105,954.96 | 0.7x Medicare |
| Montana | 3 | $99,231.05 | $101,160.12 | $105,266.39 | $126,780.12 | $180,931.52 |  |  |
| Nebraska | 1 | $69,068.54 | $69,068.54 | $69,068.54 | $69,068.54 | $69,068.54 | $91,869.50 | 0.8x Medicare |
| Nevada | 6 | $69,068.54 | $69,157.71 | $70,485.05 | $76,798.75 | $144,453.22 | $96,356.00 | 0.7x Medicare |
| New Hampshire | 4 | $69,068.54 | $69,343.09 | $83,444.05 | $112,434.58 | $147,611.10 | $127,155.24 | 0.7x Medicare |
| New Jersey | 31 | $69,068.54 | $75,826.17 | $80,266.79 | $131,383.00 | $178,950.11 | $110,716.55 | 0.7x Medicare |
| New Mexico | 2 | $69,068.54 | $69,157.71 | $69,246.88 | $72,761.17 | $76,275.46 | $76,707.39 | 0.9x Medicare |
| New York | 567 | $55,630.61 | $108,729.65 | $180,931.52 | $180,931.52 | $183,834.07 | $127,182.71 | 1.4x Medicare |
| North Carolina | 28 | $55,630.61 | $69,068.54 | $75,261.70 | $99,231.05 | $180,931.52 | $89,055.26 | 0.8x Medicare |
| North Dakota | 2 | $76,798.75 | $86,760.06 | $96,721.37 | $107,196.85 | $117,672.32 |  |  |
| Ohio | 3,684 | $55,630.61 | $69,068.54 | $69,068.54 | $69,068.54 | $180,931.52 | $99,920.25 | 0.7x Medicare |
| Oklahoma | 5 | $69,068.54 | $69,068.54 | $69,157.71 | $77,392.37 | $176,090.40 | $63,737.00 | 1.1x Medicare |
| Oregon | 2 | $67,214.68 | $69,610.70 | $72,006.72 | $74,402.73 | $76,798.75 | $104,563.63 | 0.7x Medicare |
| Pennsylvania | 2,079 | $55,630.61 | $78,768.38 | $83,869.04 | $111,667.14 | $212,786.07 | $113,213.40 | 0.7x Medicare |
| Rhode Island | 3 | $69,068.54 | $69,068.54 | $74,588.04 | $104,103.25 | $176,090.40 |  |  |
| South Carolina | 13 | $55,630.61 | $69,068.54 | $76,275.46 | $79,280.33 | $180,931.52 | $92,926.63 | 0.8x Medicare |
| South Dakota | 5 | $67,214.68 | $69,068.54 | $69,068.54 | $69,068.54 | $69,068.54 |  |  |
| Tennessee | 13 | $67,214.68 | $69,068.54 | $69,246.88 | $86,657.50 | $150,090.70 | $83,272.56 | 0.8x Medicare |
| Texas | 42 | $67,214.68 | $69,068.54 | $77,380.83 | $144,453.22 | $180,931.52 | $91,193.29 | 0.8x Medicare |
| Utah | 2 | $69,068.54 | $69,068.54 | $69,068.54 | $69,068.54 | $69,068.54 |  |  |
| Vermont | 1 | $70,485.05 | $88,977.09 | $107,469.14 | $125,961.18 | $144,453.22 | $79,631.86 | 1.4x Medicare |
| Virginia | 34 | $67,214.68 | $69,202.30 | $80,107.53 | $106,940.74 | $180,931.52 | $98,281.96 | 0.8x Medicare |
| Washington | 10 | $55,630.61 | $69,068.54 | $69,068.54 | $69,776.80 | $180,931.52 | $91,188.53 | 0.8x Medicare |
| West Virginia | 193 | $55,630.61 | $69,068.54 | $69,246.88 | $76,275.46 | $144,453.22 | $88,552.29 | 0.8x Medicare |
| Wisconsin | 8 | $67,214.68 | $69,068.54 | $69,068.54 | $69,113.13 | $95,469.66 | $116,475.63 | 0.6x Medicare |
| Wyoming | 1 | $180,931.52 | $180,931.52 | $180,931.52 | $180,931.52 | $180,931.52 | $89,122.30 | 2.0x 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/upmc/statemap_216_US.html  
About this insurer's data, and its other procedures: [index.md](index.md)