Hospital Pricing Specialists — which shared data from Humana on PPO rates for diabetes with complications (CPT code MS-DRG 638 ) with Becker’s on Nov. 1 — has been involved in more than 1,200 pricing projects, ranging from critical access hospitals to healthcare systems.
Humana PPO plans paid major health systems an average of $13,578 for diabetes with complications, according to the report. The organization looked at institutional payment rates, excluding physician fees.
Here are the Humana PPO payment rates, according to the report:
- $31,998 – Memorial Hermann (Houston)
- $24,919 – Kettering (Ohio) Health
- $19,629 – WellStar Health System (Marietta, Ga.)
- $19,111 – BayCare Health System (Clearwater, Fla.)
- $18,845 – UCHealth (Aurora, Colo.)
- $18,623 – Banner Health (Phoenix)
- $15,732 – Advocate Health (Charlotte, N.C.)
- $14,248 – HCA Healthcare (Nashville, Tenn.)
- $14,125 – Baylor Scott & White Health (Dallas)
- $13,918 – Piedmont Healthcare (Atlanta)
- $13,866 – Orlando Health (Fla.)
- $13,832 – OSF Healthcare System (Peoria, Ill.)
- $13,379 – Ascension Health (St. Louis)
- $13,343 – Ardent Health Services (Nashville, Tenn.)
- $13,079 – SSM Health Care (St. Louis)
- $12,620 – Tenet Healthcare (Dallas)
- $12,267 – Christus Health (Irving, Texas)
- $11,912 – Steward Health Care System (Dallas)
- $11,838 – Emory Healthcare (Atlanta)
- $11,691 – Universal Health Services (King of Prussia, Pa.)
- $11,283 – Saint Elizabeth Healthcare (Edgewood, Ky.)
- $11,062 – Franciscan Health (Mishawaka, Ind.)
- $10,569 – Community Health Systems (Franklin, Tenn.)
- $10,547 – CommonSpirit Health (Chicago)
- $10,376 – University Hospitals (Cleveland)
- $10,024 – AdventHealth ( Altamonte Springs, Fla.)
- $9,650 – Baptist Health (Louisville)
- $8,344 – Critical access hospitals
- $6,927 – Mercy (Chesterfield, Mo.)
- $6,794 – Baptist Memorial Care Health (Memphis, Tenn.)
- $6,376 – Ballad Health (Johnson City, Tenn.)
