Highmark: disclosed hospital rates

iDirect answer

Based on the published hospital price files, Highmark appears in disclosed negotiated rates across 19 hospitals and 708 services. This is public hospital price transparency data, not a guaranteed estimate of your bill.

Actual patient responsibility may vary based on your insurance plan, deductible, coinsurance, network status, diagnosis, setting, bundled services, clinical circumstances, and hospital billing practices.

708 prices shown.

Service	Hospital	Code	List price	Cash price	Negotiated range	Allowed (median)
17-hydroxypregnenolone (hormone) level Outpatient	Jefferson Bucks Hospital	84143 CPT	—	—	$15.97 – $252	—
17-hydroxypregnenolone (hormone) level Outpatient	Jefferson Cherry Hill Hospital	84143 CPT	—	—	$15.97 – $321	—
17-hydroxypregnenolone (hormone) level Outpatient	Jefferson Frankford Hospital	84143 CPT	—	—	$15.97 – $252	—
17-hydroxypregnenolone (hormone) level Outpatient	Jefferson Lansdale Hospital	84143 CPT	—	—	$15.97 – $1,503	—
ABATACEPT 250 MG IV SOLR Inpatient	Penn Medicine Lancaster General Health	J0129 HCPCS	$4,483	$4,483	$1,278 – $4,483	—
ABATACEPT 250 MG IV SOLR Outpatient	Penn Medicine Lancaster General Health	J0129 HCPCS	$4,483	$4,483	$44.11 – $13,500	—
ACUTE MAJOR EYE INFECTIONS WITH CC/MCC Inpatient	Jefferson Einstein Philadelphia Hospital	121 MS-DRG	—	$16,040	$9,604 – $32,020	—
ACUTE MAJOR EYE INFECTIONS WITH CC/MCC Inpatient	Jefferson Einstein Montgomery Hospital	121 MS-DRG	—	$16,040	$8,659 – $32,020	—
ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC Inpatient	Jefferson Einstein Philadelphia Hospital	122 MS-DRG	—	$11,083	$5,839 – $20,069	—
ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC Inpatient	Jefferson Einstein Montgomery Hospital	122 MS-DRG	—	$11,083	$5,122 – $20,069	—
ALLOGENEIC BONE MARROW TRANSPLANT Inpatient	Jefferson Einstein Philadelphia Hospital	14 MS-DRG	—	$158,574	$99,320 – $384,800	—
ALLOGENEIC BONE MARROW TRANSPLANT Inpatient	Jefferson Einstein Montgomery Hospital	14 MS-DRG	—	$158,574	$89,783 – $384,800	—
ALPROSTADIL 500 MCG/ML IJ SOLN Inpatient	Penn Medicine Lancaster General Health	J0270 HCPCS	$369	$369	$105 – $369	—
ALPROSTADIL 500 MCG/ML IJ SOLN Outpatient	Penn Medicine Lancaster General Health	J0270 HCPCS	$369	$369	$0.79 – $13,500	—
ALTEPLASE (TPA) 1 MG/ML SYRINGE EVD CLEARANCE Outpatient	Penn Presbyterian Medical Center	J2997 HCPCS	$255	$255	$30.86 – $469	—
ALTEPLASE (TPA) 1 MG/ML SYRINGE EVD CLEARANCE Outpatient	Pennsylvania Hospital	J2997 HCPCS	$255	$255	$34.43 – $282	—
ALTEPLASE (TPA) 1 MG/ML SYRINGE EVD CLEARANCE Outpatient	Penn Medicine Chester County Hospital	J2997 HCPCS	$255	$255	$41.57 – $298	—
ALTEPLASE (TPA) INJECTION 1MG/ML ORD Outpatient	Penn Presbyterian Medical Center	J2997 HCPCS	$308	$308	$37.27 – $469	—
ALTEPLASE (TPA) INJECTION 1MG/ML ORD Outpatient	Pennsylvania Hospital	J2997 HCPCS	$308	$308	$41.58 – $282	—
ALTEPLASE (TPA) INJECTION 1MG/ML ORD Outpatient	Penn Medicine Chester County Hospital	J2997 HCPCS	$308	$308	$50.20 – $298	—
ALTEPLASE (TPA) INJECTION 5MG/5ML ORD Outpatient	Penn Presbyterian Medical Center	J2997 HCPCS	$1,372	$1,372	$93.83 – $1,372	—
ALTEPLASE (TPA) INJECTION 5MG/5ML ORD Outpatient	Pennsylvania Hospital	J2997 HCPCS	$1,372	$1,372	$93.83 – $282	—
ALTEPLASE (TPA) INJECTION 5MG/5ML ORD Outpatient	Penn Medicine Chester County Hospital	J2997 HCPCS	$1,372	$1,372	$93.83 – $298	—
ALTEPLASE TPA 1 MG ML SYRINGE EVD CLEARANCE Outpatient	The Hospital of the University of Pennsylvania	J2997 HCPCS	$255	$255	$28.56 – $298	—
AMINOCAPROIC ACID IVPB 10G 100ML NSS CNR Outpatient	The Hospital of the University of Pennsylvania	J0290 HCPCS	$75.00	$75.00	$0.49 – $75.00	—