Vlada · Research · 2026-08-05 · observed
One hospital. One surgery. Ten different prices.
One hospital · one operation · what each plan pays
| Hospital for Special Surgery, New York | Value |
|---|---|
| UnitedHealthcareEmployer plan | 3,752.15 |
| Anthem NYEmployer plan | 3,332.31 |
| AetnaEmployer plan | 3,201.84 |
| NYSHIPState employee plan | 3,022.87 |
| CignaEmployer plan | 2,726.6 |
| EmblemHealthEmployer plan | 2,389.07 |
| UnitedHealthcareMedicare Advantage | 1,365.18 |
| FidelisLow-cost state plan | 1,228.67 |
| FidelisMedicaid | 1,023.89 |
| MetroPlusMedicaid | 739.53 |
Negotiated dollar rate · USD · file version 2026-05 · CPT 29867, facility-rate rows, professional billing class · Hospital price transparency file, CCN 330270, as published · 10 rows
The posted figure
Read with
- One hospital. This is the shape of the thing, not a national finding.
- Professional billing class: the surgeon's fee for the procedure, not the whole episode and not the facility DRG.
- Office-rate rows excluded as a different site of service.
- The ladder contains Medicare Advantage and Medicaid managed care, not traditional Medicare, so it cannot support a claim about a multiple of the Medicare rate.
- payer_name in the source table is free text, not canonical.
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