Hospital Price Engine

Payer scorecard

Same hospital, same procedure — different price depending on who’s paying. Each payer’s median negotiated rate as a percent of Medicare, across every hospital × procedure cell where that payer publishes commercial rates. Spread is the typical same-procedure price ratio between this payer’s cheapest and most expensive hospitals (10th–90th percentile, median across procedures): a low median with a wide spread still overpays somewhere.

How to read “% of Medicare”: Medicare’s payment is a hospital-specific benchmark built from CMS files — adjusted for local wages and case complexity, and roughly pegged to the cost of care. A commercial rate at 300% means a private plan pays about triple that benchmark for the same care at the same hospital. The gap is negotiation, not quality. Full methodology →
PayerMedian vs. MedicareMedian Spread (10th–90th)Hospitals Cells
Anthem BCBS
192%3.0×1054,510
Humana
229%8.0×19765
UnitedHealthcare
235%7.5×993,625
Aetna
256%6.9×823,176
Cigna
291%4.0×552,129
Cells are hospital × procedure medians per payer group; related plan names are grouped (e.g. Anthem, BCBS, and Anthem Pathway roll up to Anthem BCBS). Workers’ comp payers and Medicare Advantage are classified separately and excluded, as are data-flagged cells. Payer groups with fewer than 100 usable cells are not ranked. Plan-level scorecards and employer-weighted baskets are available through andrew@rexroadanalytics.com.
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Rexroad Analytics · Data: hospital machine-readable files (45 CFR 180, schema v3.0) retrieved August 21–22, 2026; Medicare benchmarks from CMS claims data and fee schedules; cost estimates from FY2026 CMS cost-report ratios, labeled as estimates. Not medical, legal, or benefits advice. Full methodology → · The American Healthcare Conundrum →