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Eli Lilly

Scales up logic from Sample Reviews to identify provider-payer-networks where we were able to successfully infer a Medicare Advantage percentage of Medicare.

Medicare Advantage Coverage Summary

health_system_nameprovider_idpayer_idprovider_network
Baptist Health18465
Baptist Health Care326
Baptist Health South Florida122
Baptist Health System - San Antonio TX123
Duke Health133
Duke LifePoint Healthcare8421
Henry Ford Health6211
Indiana University Health10340
Memorial Hermann Health System12448
Ochsner Health System5310
Ochsner LSU Health System of North Louisiana234
Ochsner Lafayette General Foundation5315
Ochsner Rush Health122
Vanderbilt Health5315

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Code
df = pd.read_sql(f"""
-- 🍙🍙🍙
WITH
provider_payers AS (
SELECT
hr.*,
negotiated_percentage * gross_charge AS perc_to_dol,
h.provider_name_short,
phs.provider_id AS provider_healthsystem_id,
phs.provider_name_short as provider_healthsystem_name
FROM glue.hospital_data.hospital_rates hr
JOIN tq_production.spines.spines_provider_hospitals h
ON hr.provider_id = h.provider_id
JOIN tq_production.spines.spines_provider_healthsystems phs
ON h.provider_healthsystem_id = phs.provider_id
WHERE hr.payer_class_name = 'Medicare Advantage'
AND hr.payer_id IN (643, 7, 510, 522, 42) -- UHC, Aetna, Humana, Kaiser, Anthem
AND phs.provider_id IN (
'100039','100815','100041','100224','100037','100038','100040',
'100771','100052','100482','100681','100160','100876','100230',
'100247','100312','100582','100419','100371','100269','101033','101235'
)
AND COALESCE(hr.billing_class, '') != 'Professional'
AND hr.billing_code_type = 'MS-DRG'
),
medicare AS (
SELECT DISTINCT
fy,
msdrg AS billing_code,
weights
FROM tq_intermediate.cld_utils.msdrg_weights_by_year
),
combined AS (
SELECT
pp.*,
m.*,
1.000 * pp.negotiated_dollar / NULLIF(m.weights,0) AS base
FROM provider_payers pp
LEFT JOIN medicare m
ON pp.billing_code = m.billing_code
),
medicare_rates AS (
-- USE 863 since it has 1.000 weight in FY 2025
SELECT provider_id, total_operating_and_capital_pay, federal_portion
FROM tq_production.reference_legacy.ipps_reference_pricing
WHERE
msdrg = '863'
),
final AS (
SELECT
provider_id,
payer_id,
provider_name_short,
health_system_name,
payer_name,
CASE
WHEN plan_name LIKE '%HMO%' THEN 'HMO'
ELSE 'PPO'
END AS network_type,
fy,
min(base) as min,
APPROX_PERCENTILE(base, 0.10) AS p10,
APPROX_PERCENTILE(base, 0.50) AS median,
APPROX_PERCENTILE(base, 0.90) AS p90,
max(base) as max,
stddev(base) as std,
ROW_NUMBER() OVER (
PARTITION BY
provider_id,
payer_id,
CASE
WHEN plan_name LIKE '%HMO%' THEN 'HMO'
ELSE 'PPO'
END
ORDER BY
stddev(base)
) AS row_num
FROM combined
GROUP BY 1,2,3,4,5,6,7
)
SELECT
f.provider_id,
f.payer_id,
f.provider_name_short,
f.health_system_name,
f.payer_name,
f.network_type,
f.fy,
f.min,
f.p10,
f.median,
f.p90,
f.max,
f.std,
mr.federal_portion,
mr.total_operating_and_capital_pay,
1.000 * mr.federal_portion / NULLIF(f.median, 0) AS federal_portion_ratio,
1.000 * mr.total_operating_and_capital_pay / NULLIF(f.median, 0) AS total_operating_and_capital_pay_ratio
FROM final f
LEFT JOIN medicare_rates mr
ON f.provider_id = CAST(mr.provider_id AS VARCHAR)
WHERE row_num = 1
AND f.median IS NOT NULL
AND f.std < 1000
AND
(
1.000 * mr.federal_portion / NULLIF(f.median, 0) BETWEEN 0.5 AND 10
OR
1.000 * mr.total_operating_and_capital_pay / NULLIF(f.median, 0) BETWEEN 0.5 AND 10
)
""", con=trino_conn)

# %%
df.to_excel('medicare_advantage_data.xlsx', index=False)

# %%
print(df.to_markdown(index=False))

Scope:

Health Systems:

  • Baptist, Corewell, Duke, Henry Ford, Indiana University, Memorial Hermann, Ochsner, Vanderbilt

Payers:

  • UHC, Aetna, Humana, Kaiser, Anthem (643, 7, 510, 522, 42)

Results:

Download excel here.

provider_idnpipayer_idprovider_name_shorthealth_system_namepayer_namenetwork_typefyminp10medianp90maxstdfederal_portiontotal_operating_and_capital_payfederal_portion_ratiototal_operating_and_capital_pay_ratio
22161700979465510Baptist HospitalBaptist Health CareHumanaPPO20245372.165372.175372.175372.176780.93111.9556487.0984810.8281320.633436
221617009794657Baptist HospitalBaptist Health CareAetnaPPO20245372.165372.175372.175372.176780.93111.9976487.0984810.8281320.633436
21551821155912510Baptist Medical Center BeachesBaptist HealthHumanaPPO20255213.126652.66652.66652.619997.63205.9226651.947870.121.00010.845299
805117005538567Wolfson Childrens HospitalBaptist HealthAetnaHMO20255663.976652.66652.66652.616918.4563.50426651.948626.531.00010.771179
1741538133814643Ochsner Lafayette General Orthopaedic HospitalOchsner Lafayette General FoundationUnited HealthcarePPO20246639.386675.056770.316941.188372.98144.106623.73inf1.02213
14951114292141510Twin County Regional HospitalDuke LifePoint HealthcareHumanaPPO20257128.018266.728266.728266.728266.7389.27126314.498648.531.309170.955853
34661922052869643Vanderbilt Tullahoma-Harton HospitalVanderbilt HealthUnited HealthcarePPO20255541.027213.37213.37213.37213.31134.9826239.757378.321.156020.977634
54231932152337522Memorial Hermann Katy HospitalMemorial Hermann Health SystemKaiser PermanentePPO20246764.466764.476764.476764.476764.480.002279706623.73inf1.02125
47791043533706510Slidell Memorial Hospital EastOchsner Health SystemHumanaPPO20246527.016562.456658.986829.738228.78159.0135927.646911.921.123380.963405
16951164707725643Maria Parham Medical CenterDuke LifePoint HealthcareUnited HealthcarePPO20255485.476631.466631.466631.466631.4774.78096183.498781.561.072450.755157
344813968822057Vanderbilt University Medical CenterVanderbilt HealthAetnaPPO20258493.5211056.911056.911056.911056.9206.9065841.49719.141.892841.13764
34481396882205510Vanderbilt University Medical CenterVanderbilt HealthHumanaPPO20255081.6610749.710749.710749.710749.7629.0765841.49719.141.840261.10604
25581326296211643IU Health Arnett HospitalIndiana University HealthUnited HealthcarePPO20257725.567828.018043.648402.9710432.1232.58706623.73inf1.21437
478115785684817Slidell Memorial HospitalOchsner Health SystemAetnaPPO20246527.016562.286659.26829.78228.78159.0135867.276728.131.134970.989755
297017109183627Henry Ford Kingswood HospitalHenry Ford HealthAetnaPPO20245946.625946.627070.527070.527070.52794.71906623.73inf1.06745
52116593131467Memorial Hermann Orthopedic & Spine HospitalMemorial Hermann Health SystemAetnaPPO20248424.058424.058424.058424.058424.050.0018214206623.73inf1.2718
21171518024462510Baptist Medical Center NassauBaptist HealthHumanaPPO20256186.936652.66652.66652.616652.6128.90756651.948349.941.00010.796725
467316997789857Ochsner Lafayette General Surgical HospitalOchsner Lafayette General FoundationAetnaPPO2024313.1376669.776768.476939.828372.98831.47406623.73inf1.02185
11261801897038643Conemaugh Memorial Medical CenterDuke LifePoint HealthcareUnited HealthcarePPO20256753.418791.588791.588791.588791.59120.1376363.779304.71.38150.944854
36861912079625643Ochsner Watkins Memorial HospitalOchsner Rush HealthUnited HealthcarePPO20246481.396725.217317.088384.6714061.3700.70306623.73inf1.10468
208219523519837Doctors HospitalBaptist Health South FloridaAetnaPPO20258556.018719.899142.319936.4514041.1596.0386651.948520.971.374381.07292
33181568452290510Baptist Health RichmondBaptist HealthHumanaPPO20256437.248379.898380.828381.718394.28176.2246425.377928.581.304331.05704
469811149211607Jennings American Legion HospitalOchsner Lafayette General FoundationAetnaPPO20247308.577358.287464.757623.378518.54127.7765783.497311.431.29071.02097
214015786204497Baptist Medical Center JacksonvilleBaptist HealthAetnaHMO2025889.4126633.756633.756633.7613142.2453.8456651.948626.530.9972660.768994
305919927253527Henry Ford Wyandotte HospitalHenry Ford HealthAetnaPPO20247084.447219.927530.47833.469435.75236.8296485.338230.631.161140.914924
17561811158215510Haywood Regional Medical CenterDuke LifePoint HealthcareHumanaPPO20255577.596742.826742.826742.826742.8392.00156183.497633.951.090460.883268
35721942391230510Prattville Baptist HospitalBaptist HealthHumanaPPO20256764.976935.187292.827888.7511252.3385.7025932.577267.021.229291.00355
17151073568754510Duke Health Lake Norman HospitalDuke HealthHumanaPPO20256755.176918.267207.437620.4310903.3385.96506623.73inf1.08812
171510735687547Duke Health Lake Norman HospitalDuke HealthAetnaPPO20256890.257051.467351.527770.2411121.3389.15906623.73inf1.10988
80491174297626643Baptist Medical Center ClayBaptist HealthUnited HealthcareHMO20254902.496633.756633.756633.769042.16237.84406623.73inf1.00151
25621205860335510IU Health Bloomington HospitalIndiana University HealthHumanaPPO20257647.527751.767968.968331.4410380.2234.8336978.88340.151.141880.955494
32451689282147643Baptist Health HardinBaptist HealthUnited HealthcarePPO20255142.626694.66694.986695.876706.06127.0766174.047021.51.084370.953497
539019826661117Memorial Hermann - Texas Medical CenterMemorial Hermann Health SystemAetnaPPO20248424.048424.058424.058424.058424.060.002243346635.8213612.81.269480.618834
80731255577466643Monroe Carell Jr Childrens Hospital at VanderbiltVanderbilt HealthUnited HealthcarePPO20257864.3710237.810237.810237.810237.8193.5985841.49719.141.752631.05337
53971740233782522Memorial Hermann Memorial City Medical CenterMemorial Hermann Health SystemKaiser PermanentePPO20246831.746831.756831.756831.756831.760.0023936635.82100151.029530.682148
68451144266024643IU Health Methodist HospitalIndiana University HealthUnited HealthcarePPO20258174.218404.288888.519691.0114253522.4346978.811010.61.273640.807266
29591134144801510Henry Ford HospitalHenry Ford HealthHumanaPPO20247406.697602.087969.738601.5912060.2422.7766485.3311286.11.228890.706156
17415381338147Ochsner Lafayette General Orthopaedic HospitalOchsner Lafayette General FoundationAetnaPPO2024313.1376669.756768.76938.938372.98831.47406623.73inf1.02189
1741538133814510Ochsner Lafayette General Orthopaedic HospitalOchsner Lafayette General FoundationHumanaPPO2024313.1376661.136760.036931.198362.56830.33606623.73inf1.02058
16951164707725510Maria Parham Medical CenterDuke LifePoint HealthcareHumanaPPO20255485.476631.466631.466631.466631.4774.78096183.498781.561.072450.755157
17601215359922510Wilson Medical CenterDuke LifePoint HealthcareHumanaPPO20255607.97300.367300.367300.367300.37137.3036303.48666.151.158160.842399
20821952351983510Doctors HospitalBaptist Health South FloridaHumanaPPO20258271.868432.28842.139613.2813654583.5216651.948520.971.329261.03769
47601083903744510St Bernard Parish HospitalOchsner Health SystemHumanaPPO20246586.756793.767151.227618.197918.97312.9695909.987619.271.210020.93857
176012153599227Wilson Medical CenterDuke LifePoint HealthcareAetnaPPO20255607.97300.367300.367300.367300.37137.3036303.48666.151.158160.842399
47601083903744643St Bernard Parish HospitalOchsner Health SystemUnited HealthcarePPO20246586.756793.767152.687618.197918.97312.9695909.987619.271.210270.938761
17601215359922643Wilson Medical CenterDuke LifePoint HealthcareUnited HealthcarePPO20255663.987373.367373.367373.367373.37138.6766303.48666.151.169740.850823
215518211559127Baptist Medical Center BeachesBaptist HealthAetnaPPO20255213.126633.756633.756633.769969.31203.1546651.947870.120.9972660.842904
215518211559127Baptist Medical Center BeachesBaptist HealthAetnaHMO20255213.126633.756633.756633.769969.31203.1546651.947870.120.9972660.842904
21551821155912510Baptist Medical Center BeachesBaptist HealthHumanaHMO20255213.126652.66652.66652.619997.63206.0486651.947870.121.00010.845299
68541558331801510Memorial Hermann the WoodlandsMemorial Hermann Health SystemHumanaPPO20247060.237060.247060.247060.247060.250.002413276635.8210783.21.063960.654742
1495111429214142Twin County Regional HospitalDuke LifePoint HealthcareAnthemPPO20256988.258104.638104.638104.638104.6487.52086314.498648.531.28350.937111
14951114292141643Twin County Regional HospitalDuke LifePoint HealthcareUnited HealthcarePPO20256988.258104.638163.788266.728266.73119.8596314.498648.531.292860.94395
30151023114634510Henry Ford Macomb Hospital - Clinton TownshipHenry Ford HealthHumanaPPO20246731.366784.216882.57050.627983.19108.0546485.338556.631.061240.804348
542319321523377Memorial Hermann Katy HospitalMemorial Hermann Health SystemAetnaPPO20246764.466764.476764.476764.476764.480.002279706623.73inf1.02125
301510231146347Henry Ford Macomb Hospital - Clinton TownshipHenry Ford HealthAetnaPPO20246863.346945.587525.468030.849003.52466.3146485.338556.631.160380.879489
54231932152337643Memorial Hermann Katy HospitalMemorial Hermann Health SystemUnited HealthcarePPO20246764.466764.477140.167440.927440.93338.40606623.73inf1.07797
54231932152337510Memorial Hermann Katy HospitalMemorial Hermann Health SystemHumanaPPO20246764.466764.476764.476764.476764.480.002279706623.73inf1.02125
80511700553856643Wolfson Childrens HospitalBaptist HealthUnited HealthcareHMO20255663.976652.66652.66652.616918.4563.50426651.948626.531.00010.771179
80511700553856510Wolfson Childrens HospitalBaptist HealthHumanaHMO20255663.976652.66652.66652.616918.4563.50426651.948626.531.00010.771179
80511700553856643Wolfson Childrens HospitalBaptist HealthUnited HealthcarePPO20255663.976652.66652.66652.616918.4563.44536651.948626.531.00010.771179
80511700553856510Wolfson Childrens HospitalBaptist HealthHumanaPPO20255663.976652.66652.66652.616918.4563.466651.948626.531.00010.771179
805117005538567Wolfson Childrens HospitalBaptist HealthAetnaPPO20255663.976652.66652.66652.616918.4563.50426651.948626.531.00010.771179
52571669752234510Baptist Neighborhood Hospital - Thousand OaksBaptist Health System - San Antonio TXHumanaHMO20256209.296209.296209.296209.36209.30.002818466041.876604.951.027710.940097
52571669752234510Baptist Neighborhood Hospital - Thousand OaksBaptist Health System - San Antonio TXHumanaPPO20256539.576539.576539.576539.586539.580.002998066041.876604.951.082380.990102
68551568835312510Memorial Hermann Southeast HospitalMemorial Hermann Health SystemHumanaPPO20247060.237060.247060.247060.247060.250.002431266635.8210783.21.063960.654742
5211659313146510Memorial Hermann Orthopedic & Spine HospitalMemorial Hermann Health SystemHumanaPPO20248424.058424.058424.058424.058424.050.0018214206623.73inf1.2718
525716697522347Baptist Neighborhood Hospital - Thousand OaksBaptist Health System - San Antonio TXAetnaPPO20256473.516473.526473.526473.526473.530.002913236041.876604.951.071440.980101
68551568835312522Memorial Hermann Southeast HospitalMemorial Hermann Health SystemKaiser PermanentePPO20247060.237060.247060.247060.247060.250.002431266635.8210783.21.063960.654742
68551568835312643Memorial Hermann Southeast HospitalMemorial Hermann Health SystemUnited HealthcarePPO20247060.237060.247394.347766.267766.27353.1896635.8210783.21.114310.685725
685515688353127Memorial Hermann Southeast HospitalMemorial Hermann Health SystemAetnaPPO20247060.237060.247060.247060.247060.250.002431266635.8210783.21.063960.654742
5211659313146522Memorial Hermann Orthopedic & Spine HospitalMemorial Hermann Health SystemKaiser PermanentePPO20248424.058424.058424.058424.058424.050.0018214206623.73inf1.2718
29701710918362510Henry Ford Kingswood HospitalHenry Ford HealthHumanaPPO20246065.556065.557211.937211.937211.93810.61506623.73inf1.0888
5211659313146643Memorial Hermann Orthopedic & Spine HospitalMemorial Hermann Health SystemUnited HealthcarePPO20248424.058424.059266.469266.469266.46423.46406623.73inf1.39898
477614275363257Ochsner LSU Health Shreveport - Academic Medical CenterOchsner LSU Health System of North LouisianaAetnaPPO20249176.149499.6310122.211202.412469.3641.4136187.1811659.21.635990.868171
292514078675597Henry Ford West Bloomfield HospitalHenry Ford HealthAetnaPPO20247023.17091.937299.977472.778287.11146.9596485.337794.031.125610.936611
29251407867559510Henry Ford West Bloomfield HospitalHenry Ford HealthHumanaPPO20246888.046932.077014.757156.027937.5890.58966485.337794.031.081630.900016
47761427536325643Ochsner LSU Health Shreveport - Academic Medical CenterOchsner LSU Health System of North LouisianaUnited HealthcarePPO20249176.149499.6810122.711200.812469.3641.4136187.1811659.21.636070.868214
47761427536325510Ochsner LSU Health Shreveport - Academic Medical CenterOchsner LSU Health System of North LouisianaHumanaPPO20249176.149500.7610122.611202.512469.3641.4136187.1811659.21.636060.868209
34481396882205643Vanderbilt University Medical CenterVanderbilt HealthUnited HealthcarePPO20257864.3710237.810237.810237.810237.8191.585841.49719.141.752631.05337
17351881977593510Person Memorial HospitalDuke LifePoint HealthcareHumanaPPO20258988.288988.298988.298988.298988.30.002700966385.1311412.61.407690.787575
17351881977593643Person Memorial HospitalDuke LifePoint HealthcareUnited HealthcarePPO20258988.288988.298988.298988.298988.30.002700966385.1311412.61.407690.787575
25581326296211510IU Health Arnett HospitalIndiana University HealthHumanaPPO20257642.787747.657967.298333.9710403.5237.2406623.73inf1.20284
25581326296211510IU Health Arnett HospitalIndiana University HealthHumanaHMO20257492.927595.47811.158167.1410199.4232.58806623.73inf1.17927
299710534034027Henry Ford Jackson HospitalHenry Ford HealthAetnaPPO20248063.068163.868352.678672.3610454.2206.5976700.749199.281.246530.90797
255813262962117IU Health Arnett HospitalIndiana University HealthAetnaPPO20257802.817906.428124.518486.810536.4234.91306623.73inf1.22658
53951730132234643Memorial Hermann Greater Heights HospitalMemorial Hermann Health SystemUnited HealthcarePPO20247060.237060.247365.937766.267766.27353.2066635.8210783.21.110030.683091
46751669882940510Ochsner Acadia General HospitalOchsner Lafayette General FoundationHumanaPPO20247484.277536.37668.37884.459438.3169.5545783.497745.731.325890.990004
53951730132234522Memorial Hermann Greater Heights HospitalMemorial Hermann Health SystemKaiser PermanentePPO20247060.237060.247060.247060.247060.250.00246646635.8210783.21.063960.654742
29971053403402510Henry Ford Jackson HospitalHenry Ford HealthHumanaPPO20247197.487300.027492.397819.379636.49210.5216700.749199.281.118140.814454
467516698829407Ochsner Acadia General HospitalOchsner Lafayette General FoundationAetnaPPO20247484.277536.737667.937884.879438.3169.5545783.497745.731.325830.989956
53951730132234510Memorial Hermann Greater Heights HospitalMemorial Hermann Health SystemHumanaPPO20247060.237060.247060.247060.247060.250.00246646635.8210783.21.063960.654742
32401902865389510Baptist Health CorbinBaptist HealthHumanaPPO20251234.356988.676989.386990.267000.69318.2945979.87335.461.168830.952821
539517301322347Memorial Hermann Greater Heights HospitalMemorial Hermann Health SystemAetnaPPO20247060.237060.247060.247060.247060.250.00246646635.8210783.21.063960.654742
32401902865389643Baptist Health CorbinBaptist HealthUnited HealthcarePPO20256026.166988.716989.426990.257000.6959.18915979.87335.461.168840.952826
173518819775937Person Memorial HospitalDuke LifePoint HealthcareAetnaPPO20258855.88855.818855.818855.818855.820.002540326385.1311412.61.386940.775967
46751669882940643Ochsner Acadia General HospitalOchsner Lafayette General FoundationUnited HealthcarePPO20247484.277537.027668.427884.669438.3169.5545783.497745.731.325910.990019
346119321707507Vanderbilt Bedford HospitalVanderbilt HealthAetnaPPO20256742.868777.858777.858777.858777.86164.2596239.75100161.406760.876384
34611932170750643Vanderbilt Bedford HospitalVanderbilt HealthUnited HealthcarePPO20256243.398127.648127.648127.648127.65152.0926239.75100161.302560.811466
34611932170750510Vanderbilt Bedford HospitalVanderbilt HealthHumanaPPO20256555.568534.028534.028534.028534.03159.6966239.75100161.367690.85204
46981114921160510Jennings American Legion HospitalOchsner Lafayette General FoundationHumanaPPO20247308.577358.287463.757623.398518.54127.7765783.497311.431.290531.02083
46981114921160643Jennings American Legion HospitalOchsner Lafayette General FoundationUnited HealthcarePPO20247308.577357.947464.327623.398518.54127.7765783.497311.431.290621.02091
30591992725352510Henry Ford Wyandotte HospitalHenry Ford HealthHumanaPPO20246948.27035.387198.437475.769018.94178.7336485.338230.631.109960.87459
47811578568481510Slidell Memorial HospitalOchsner Health SystemHumanaPPO20246527.016562.026659.516829.578228.78159.0135867.276728.131.135030.989801
47811578568481643Slidell Memorial HospitalOchsner Health SystemUnited HealthcarePPO20246527.016562.416658.956829.698228.78159.0135867.276728.131.134930.989717
21271972664530510Gulf Breeze HospitalBaptist Health CareHumanaPPO20245340.365340.385340.385340.386740.81111.29306623.73inf0.80625
212719726645307Gulf Breeze HospitalBaptist Health CareAetnaPPO20245340.365340.385340.385340.386740.81111.33506623.73inf0.80625
55501295788735643Memorial Hermann Sugar Land HospitalMemorial Hermann Health SystemUnited HealthcarePPO20255266.346855.727078.287541.297541.3362.48906623.73inf1.06862
55501295788735510Memorial Hermann Sugar Land HospitalMemorial Hermann Health SystemHumanaPPO20255266.346855.726855.726855.726855.73113.24406623.73inf1.03502
73241730140591643IU Health MorganIndiana University HealthUnited HealthcarePPO20258174.218405.498889.999693.2614253522.4346978.811010.61.273860.807401
73241730140591510IU Health MorganIndiana University HealthHumanaHMO20257527.297757.498242.939046.7313606.1522.4396978.811010.61.181140.748634
73241730140591510IU Health MorganIndiana University HealthHumanaPPO20257677.837912.598405.149224.3613878.2532.8886978.811010.61.204380.763366
55501295788735522Memorial Hermann Sugar Land HospitalMemorial Hermann Health SystemKaiser PermanentePPO20255266.346855.726855.726855.726855.73113.24406623.73inf1.03502
555012957887357Memorial Hermann Sugar Land HospitalMemorial Hermann Health SystemAetnaPPO20255266.346855.726855.726855.726855.73113.24406623.73inf1.03502
732417301405917IU Health MorganIndiana University HealthAetnaPPO20258255.958489.318976.059789.7814395.5527.6596978.811010.61.286190.815217
326612655394987Baptist Health LouisvilleBaptist HealthAetnaPPO20255064.896593.416593.766594.66604.71101.9276174.046772.981.067980.973539
32661265539498643Baptist Health LouisvilleBaptist HealthUnited HealthcarePPO20255064.896593.416593.766594.596604.71101.9276174.046772.981.067980.973539
25501568492916643IU Health North HospitalIndiana University HealthUnited HealthcarePPO20257678.727756.487920.298192.429731.68176.4136978.88092.991.134910.978661
46731699778985643Ochsner Lafayette General Surgical HospitalOchsner Lafayette General FoundationUnited HealthcarePPO20246639.386675.16770.246939.838372.98144.106623.73inf1.02212
255015684929167IU Health North HospitalIndiana University HealthAetnaPPO20257755.517834.037998.48274.839829.03178.1786978.88092.991.14610.988313
25501568492916510IU Health North HospitalIndiana University HealthHumanaHMO20257534.397612.027775.478049.29587.39176.4146978.88092.991.114150.960766
32661265539498510Baptist Health LouisvilleBaptist HealthHumanaPPO2025784.2436659.296659.696660.536670.75401.126174.046772.981.078660.983274
46731699778985510Ochsner Lafayette General Surgical HospitalOchsner Lafayette General FoundationHumanaPPO2024313.1376661.576759.776931.138362.56830.33606623.73inf1.02054
25501568492916510IU Health North HospitalIndiana University HealthHumanaPPO20257685.077764.347931.368208.879779.13179.9436978.88092.991.136490.980029
47411215939210510Ochsner LSU Health Shreveport - Monroe Medical CenterOchsner LSU Health System of North LouisianaHumanaPPO20246927.96927.916927.916927.918653.9131.9815783.499463.311.197880.732081
17491407962046510Harris Regional HospitalDuke LifePoint HealthcareHumanaPPO20256430.77774.167774.167774.167774.17117.1746183.499001.021.257250.863698
32671306925540643Baptist Health La GrangeBaptist HealthUnited HealthcarePPO20255258.216845.146845.826846.596856.79116.8976174.048915.731.108810.767836
174914079620467Harris Regional HospitalDuke LifePoint HealthcareAetnaPPO20256304.627621.737621.737621.737621.74114.8776183.499001.021.232590.846763
36861912079625510Ochsner Watkins Memorial HospitalOchsner Rush HealthHumanaPPO20246481.396715.397295.838361.5814061.3699.90606623.73inf1.10147
17491407962046643Harris Regional HospitalDuke LifePoint HealthcareUnited HealthcarePPO20256304.627621.737621.737621.737621.74114.8776183.499001.021.232590.846763
112618018970387Conemaugh Memorial Medical CenterDuke LifePoint HealthcareAetnaPPO20257023.549143.249143.249143.249143.25124.9426363.779304.71.436760.982647
326713069255407Baptist Health La GrangeBaptist HealthAetnaPPO20255258.216845.146845.826846.596856.79116.8976174.048915.731.108810.767836
346619220528697Vanderbilt Tullahoma-Harton HospitalVanderbilt HealthAetnaPPO20255984.317790.367790.367790.377790.37145.786239.757378.321.248511.05585
34661922052869510Vanderbilt Tullahoma-Harton HospitalVanderbilt HealthHumanaPPO20255818.077573.967573.967573.977573.97141.7316239.757378.321.213821.02652
21401578620449643Baptist Medical Center JacksonvilleBaptist HealthUnited HealthcarePPO20254752.596633.756633.756633.7613142.2386.0926651.948626.530.9972660.768994
21401578620449510Baptist Medical Center JacksonvilleBaptist HealthHumanaPPO20254766.096652.66652.66652.613179.5390.2476651.948626.531.00010.771179
214015786204497Baptist Medical Center JacksonvilleBaptist HealthAetnaPPO2025889.4126633.756633.756633.7613142.2453.8456651.948626.530.9972660.768994
21401578620449643Baptist Medical Center JacksonvilleBaptist HealthUnited HealthcareHMO20254752.596633.756633.756633.7613142.2386.2536651.948626.530.9972660.768994
47371710097936510Ochsner Medical Center - KennerOchsner Health SystemHumanaPPO20247822.017934.398184.688643.7111022.4319.4615909.988479.471.384890.965235
21401578620449510Baptist Medical Center JacksonvilleBaptist HealthHumanaHMO20254766.096652.66652.66652.613179.5390.416651.948626.531.00010.771179
17151073568754643Duke Health Lake Norman HospitalDuke HealthUnited HealthcarePPO20256755.176913.437208.357619.7710903.3381.9706623.73inf1.08826
33101730264128643Baptist Health PaducahBaptist HealthUnited HealthcarePPO20255405.897037.327037.717038.647049.38111.9076330.927294.331.111640.96482
35721942391230643Prattville Baptist HospitalBaptist HealthUnited HealthcarePPO20257087.117265.257639.658264.3111788.1404.0695932.577267.021.287751.05128
33101730264128510Baptist Health PaducahBaptist HealthHumanaPPO202596.47347177.987178.467179.417190.36496.7776330.927294.331.133870.984115
35661700977105510Baptist Medical Center SouthBaptist HealthHumanaPPO20257413.177801.598609.269960.0717582.4874.0815932.578928.71.451190.964223
35661700977105643Baptist Medical Center SouthBaptist HealthUnited HealthcarePPO20257766.188169.489017.5710436.518419.7915.7045932.578928.71.520011.00995
21171518024462510Baptist Medical Center NassauBaptist HealthHumanaHMO20256186.936652.66652.66652.616652.6128.93556651.948349.941.00010.796725
21171518024462643Baptist Medical Center NassauBaptist HealthUnited HealthcarePPO20256652.66652.66652.66652.616652.610.002767996651.948349.941.00010.796725
211715180244627Baptist Medical Center NassauBaptist HealthAetnaHMO20256186.936652.66652.66652.616652.6128.93556651.948349.941.00010.796725
211715180244627Baptist Medical Center NassauBaptist HealthAetnaPPO20256186.936652.66652.66652.616652.6128.93556651.948349.941.00010.796725
21171518024462643Baptist Medical Center NassauBaptist HealthUnited HealthcareHMO20256652.66652.66652.66652.616652.610.002771576651.948349.941.00010.796725
264014977988477Baptist Health FloydBaptist HealthAetnaPPO20255770.437511.887512.297513.317524.7482.611606623.73inf1.13415
26401497798847643Baptist Health FloydBaptist HealthUnited HealthcarePPO20252824.727136.277136.677137.647148.51207.76406623.73inf1.07744
26401497798847510Baptist Health FloydBaptist HealthHumanaPPO20255770.437511.887512.297513.317524.7483.336306623.73inf1.13415
17561811158215643Haywood Regional Medical CenterDuke LifePoint HealthcareUnited HealthcarePPO20255468.236610.616610.616610.616610.6290.19736183.497633.951.069070.865949
17361245321181510Rutherford Regional Medical CenterDuke LifePoint HealthcareHumanaPPO20257046.687639.717639.717639.717639.7237.70626183.498686.031.23550.87954
80491174297626510Baptist Medical Center ClayBaptist HealthHumanaHMO20254916.426652.66652.66652.619067.85241.09906623.73inf1.00436
80491174297626643Baptist Medical Center ClayBaptist HealthUnited HealthcarePPO20254902.496633.756633.756633.769042.16237.64506623.73inf1.00151
804911742976267Baptist Medical Center ClayBaptist HealthAetnaHMO20254902.496633.756633.756633.769042.16239.32706623.73inf1.00151
804911742976267Baptist Medical Center ClayBaptist HealthAetnaPPO20254902.496633.756633.756633.769042.16239.32706623.73inf1.00151
80491174297626510Baptist Medical Center ClayBaptist HealthHumanaPPO20254916.426652.66652.66652.619067.85241.09906623.73inf1.00436
46421053360651510Ochsner Medical Center - Baton RougeOchsner Health SystemHumanaPPO20247467.097520.637655.397893.099359.63174.2025928.057683.641.291380.996323
477910435337067Slidell Memorial Hospital EastOchsner Health SystemAetnaPPO20246527.016562.376659.336830.88228.78159.0135927.646911.921.123440.963455
47791043533706643Slidell Memorial Hospital EastOchsner Health SystemUnited HealthcarePPO20246527.016562.366659.436829.878228.78159.0135927.646911.921.123450.96347
68471144266024643IU Health Saxony HospitalIndiana University HealthUnited HealthcarePPO20258174.218404.298888.869694.1514253522.4346978.811010.61.273690.807298
684711442660247IU Health Saxony HospitalIndiana University HealthAetnaPPO20258255.958490.148977.119788.1414395.5527.6596978.811010.61.286340.815313
329514472319567Baptist Health Deaconess MadisonvilleBaptist HealthAetnaPPO20257628.197631.937642.97856.599072.17110.72606623.73inf1.15387
68471144266024510IU Health Saxony HospitalIndiana University HealthHumanaPPO20257677.837912.768407.49229.4613878.2532.8886978.811010.61.20470.763571
68471144266024510IU Health Saxony HospitalIndiana University HealthHumanaHMO20257527.297757.088241.419048.7513606.1522.4396978.811010.61.180920.748496
32951447231956510Baptist Health Deaconess MadisonvilleBaptist HealthHumanaPPO20257628.197631.937643.27856.69072.17110.88306623.73inf1.15391
3295144723195642Baptist Health Deaconess MadisonvilleBaptist HealthAnthemPPO20257628.197631.947643.177856.149072.17110.68506623.73inf1.15391
33181568452290643Baptist Health RichmondBaptist HealthUnited HealthcarePPO20255574.817257.27258.017258.777269.65152.6146425.377928.581.129590.915423
331815684522907Baptist Health RichmondBaptist HealthAetnaPPO20255574.817257.27258.027258.777269.65152.6146425.377928.581.129590.915424
25281891004057643IU Health University HospitalIndiana University HealthUnited HealthcarePPO20257638.897739.77952.178305.3910304229.02106623.73inf1.20056
25281891004057510IU Health University HospitalIndiana University HealthHumanaHMO20257517.457618.347829.968183.5910182.5229.02206623.73inf1.18211
72791013143452522Memorial Hermann Southwest HospitalMemorial Hermann Health SystemKaiser PermanentePPO20247060.237060.247060.247060.247060.250.002426246635.8210783.21.063960.654742
72791013143452510Memorial Hermann Southwest HospitalMemorial Hermann Health SystemHumanaPPO20247060.237060.247060.247060.247060.250.002426246635.8210783.21.063960.654742
53901982666111510Memorial Hermann - Texas Medical CenterMemorial Hermann Health SystemHumanaPPO20248424.048424.058424.058424.058424.060.002243346635.8213612.81.269480.618834
72791013143452643Memorial Hermann Southwest HospitalMemorial Hermann Health SystemUnited HealthcarePPO20247060.237060.247378.347766.267766.27353.1926635.8210783.21.11190.684242
32451689282147510Baptist Health HardinBaptist HealthHumanaPPO20255142.626694.596694.986695.929936.36218.3936174.047021.51.084380.953497
805014479241547Baptist Medical Center SouthBaptist HealthAetnaHMO20254175.826633.756633.756633.7612225.7307.0346651.948626.530.9972660.768994
80501447924154510Baptist Medical Center SouthBaptist HealthHumanaHMO20254187.696652.66652.66652.612260.4308.3186651.948626.531.00010.771179
324516892821477Baptist Health HardinBaptist HealthAetnaPPO20255142.626694.66694.976695.886706.06127.0766174.047021.51.084370.953496
53901982666111522Memorial Hermann - Texas Medical CenterMemorial Hermann Health SystemKaiser PermanentePPO20248424.048424.058424.058424.058424.060.002243346635.8213612.81.269480.618834
80501447924154510Baptist Medical Center SouthBaptist HealthHumanaPPO20254187.696652.66652.66652.612260.4308.3186651.948626.531.00010.771179
3245168928214742Baptist Health HardinBaptist HealthAnthemPPO20255142.626694.66694.976695.896706.06127.0766174.047021.51.084370.953496
25621205860335643IU Health Bloomington HospitalIndiana University HealthUnited HealthcarePPO20257798.387899.538112.518468.0510477.5230.2276978.88340.151.162450.972705
80501447924154643Baptist Medical Center SouthBaptist HealthUnited HealthcarePPO20254175.826633.756633.756633.7612225.7305.9476651.948626.530.9972660.768994
25621205860335510IU Health Bloomington HospitalIndiana University HealthHumanaHMO20257497.577599.337813.148164.1110176.7230.2296978.88340.151.119550.93681
727910131434527Memorial Hermann Southwest HospitalMemorial Hermann Health SystemAetnaPPO20247060.237060.247060.247060.247060.250.002426246635.8210783.21.063960.654742
805014479241547Baptist Medical Center SouthBaptist HealthAetnaPPO20254175.826633.756633.756633.7612225.7307.0346651.948626.530.9972660.768994
80501447924154643Baptist Medical Center SouthBaptist HealthUnited HealthcareHMO20254175.826633.756633.756633.7612225.7306.1046651.948626.530.9972660.768994
252818910040577IU Health University HospitalIndiana University HealthAetnaPPO20257715.287816.748031.828388.8610407231.31206623.73inf1.21258
256212058603357IU Health Bloomington HospitalIndiana University HealthAetnaPPO20257876.377978.948194.28551.4510582.2232.5296978.88340.151.174150.9825
25281891004057510IU Health University HospitalIndiana University HealthHumanaPPO20257667.87770.747986.888347.3910386.1233.60206623.73inf1.2058
53901982666111643Memorial Hermann - Texas Medical CenterMemorial Hermann Health SystemUnited HealthcarePPO20248424.048424.058866.549266.469266.47421.3786635.8213612.81.336160.651339
25431063443455510IU Health West HospitalIndiana University HealthHumanaHMO20257517.457618.647831.088184.410182.5229.0226978.88138.881.122120.962182
25431063443455643IU Health West HospitalIndiana University HealthUnited HealthcarePPO20257638.897739.57951.968305.5710304229.0216978.88138.881.139440.977034
254310634434557IU Health West HospitalIndiana University HealthAetnaPPO20257715.2878178031.618387.1210407231.3126978.88138.881.150860.98682
25431063443455510IU Health West HospitalIndiana University HealthHumanaPPO20257667.87770.47987.588346.4610386.1233.6026978.88138.881.144550.98141
68451144266024510IU Health Methodist HospitalIndiana University HealthHumanaHMO20257527.297757.848241.959049.7813606.1522.4396978.811010.61.1810.748545
54141295843787643Memorial Hermann Northeast HospitalMemorial Hermann Health SystemUnited HealthcarePPO20246994.886994.897290.837694.387694.39349.9486635.8210561.11.098710.690347
684511442660247IU Health Methodist HospitalIndiana University HealthAetnaPPO20258255.958489.558977.519789.8514395.5527.6596978.811010.61.28640.815349
53971740233782643Memorial Hermann Memorial City Medical CenterMemorial Hermann Health SystemUnited HealthcarePPO20246831.746831.757206.937514.937514.94341.7546635.82100151.086070.71961
35731104917780510Baptist Medical Center EastBaptist HealthHumanaPPO20257098.317286.747682.288342.2212070.5427.385932.577673.581.294931.00113
541412958437877Memorial Hermann Northeast HospitalMemorial Hermann Health SystemAetnaPPO20246994.886994.896994.896994.896994.90.002490336635.8210561.11.054110.662325
53971740233782510Memorial Hermann Memorial City Medical CenterMemorial Hermann Health SystemHumanaPPO20246831.746831.756831.756831.756831.760.0023936635.82100151.029530.682148
26391225195340510IU Health Ball Memorial HospitalIndiana University HealthHumanaHMO20257510.187588.77753.968029.49585.99178.3766990.459018.681.109220.859767
26391225195340510IU Health Ball Memorial HospitalIndiana University HealthHumanaPPO20257660.387740.557909.78190.559777.73181.9446990.459018.681.13150.877035
47041275536799643Ochsner Lafayette General Medical CenterOchsner Lafayette General FoundationUnited HealthcarePPO20246639.386675.16770.316939.928372.98144.15797.056999.81.167890.967214
54141295843787510Memorial Hermann Northeast HospitalMemorial Hermann Health SystemHumanaPPO20246994.886994.896994.896994.896994.90.002490336635.8210561.11.054110.662325
35731104917780643Baptist Medical Center EastBaptist HealthUnited HealthcarePPO20257436.327634.148047.468739.112645.3447.7325932.577673.581.356491.04872
54141295843787522Memorial Hermann Northeast HospitalMemorial Hermann Health SystemKaiser PermanentePPO20246994.886994.896994.896994.896994.90.002490336635.8210561.11.054110.662325
47041275536799510Ochsner Lafayette General Medical CenterOchsner Lafayette General FoundationHumanaPPO2024313.1376661.366760.176930.618362.56830.3365797.056999.81.166140.965766
26391225195340643IU Health Ball Memorial HospitalIndiana University HealthUnited HealthcarePPO20257834.317912.498078.478353.199910.11178.3746990.459018.681.155640.895749
263912251953407IU Health Ball Memorial HospitalIndiana University HealthAetnaPPO20257912.667991.418158.978436.2710009.2180.1586990.459018.681.167160.904675
68451144266024510IU Health Methodist HospitalIndiana University HealthHumanaPPO20257677.837913.648407.29228.1513878.2532.8886978.811010.61.204680.763553
539717402337827Memorial Hermann Memorial City Medical CenterMemorial Hermann Health SystemAetnaPPO20246831.746831.756831.756831.756831.760.0023936635.82100151.029530.682148
470412755367997Ochsner Lafayette General Medical CenterOchsner Lafayette General FoundationAetnaPPO2024313.1376669.76768.516938.958372.98831.4745797.056999.81.167580.966958
73231114958584643Riley Hospital for Children at IU HealthIndiana University HealthUnited HealthcarePPO20258174.218405.878889.679695.7814253522.4346978.811010.61.273810.807371
73231114958584510Riley Hospital for Children at IU HealthIndiana University HealthHumanaHMO20257527.297758.918241.179050.9113606.1522.4396978.811010.61.180890.748474
732311149585847Riley Hospital for Children at IU HealthIndiana University HealthAetnaPPO20258255.958489.218977.119790.5614395.5527.6596978.811010.61.286340.815313
807312555774667Monroe Carell Jr Childrens Hospital at VanderbiltVanderbilt HealthAetnaPPO20258493.5211056.911056.911056.911056.9209.0865841.49719.141.892841.13764
80731255577466510Monroe Carell Jr Childrens Hospital at VanderbiltVanderbilt HealthHumanaPPO20255081.6610749.710749.710749.710749.7635.6035841.49719.141.840261.10604
73231114958584510Riley Hospital for Children at IU HealthIndiana University HealthHumanaPPO20257677.837913.048405.79227.8913878.2532.8886978.811010.61.204460.763417
227919129182777Jay HospitalBaptist Health CareAetnaPPO20245595.965595.975595.975595.977063.42116.66306623.73inf0.844837
22791912918277510Jay HospitalBaptist Health CareHumanaPPO20245595.965595.975595.975595.977063.42116.61906623.73inf0.844837
173612453211817Rutherford Regional Medical CenterDuke LifePoint HealthcareAetnaPPO20256976.917564.077564.077564.077564.0837.33256183.498686.031.223270.870832
33401306889597643Vanderbilt Wilson County HospitalVanderbilt HealthUnited HealthcarePPO20256191.418059.978059.978059.978059.98150.8266334.28284.61.272450.972886
17361245321181643Rutherford Regional Medical CenterDuke LifePoint HealthcareUnited HealthcarePPO20256976.917564.077564.077564.077564.0837.29666183.498686.031.223270.870832
33401306889597510Vanderbilt Wilson County HospitalVanderbilt HealthHumanaPPO20256500.988462.968462.978462.978462.98158.3676334.28284.61.336071.02153
334013068895977Vanderbilt Wilson County HospitalVanderbilt HealthAetnaPPO20256686.728704.768704.778704.778704.78162.8926334.28284.61.374251.05072
685612657722637Memorial Hermann Pearland HospitalMemorial Hermann Health SystemAetnaPPO20247060.237060.247060.247060.247060.250.0024706806623.73inf1.0659
68561265772263643Memorial Hermann Pearland HospitalMemorial Hermann Health SystemUnited HealthcarePPO20247060.237060.247424.647766.267766.27353.27906623.73inf1.12091
68561265772263510Memorial Hermann Pearland HospitalMemorial Hermann Health SystemHumanaPPO20247060.237060.247060.247060.247060.250.0024706806623.73inf1.0659
68541558331801522Memorial Hermann the WoodlandsMemorial Hermann Health SystemKaiser PermanentePPO20247060.237060.247060.247060.247060.250.002413276635.8210783.21.063960.654742
327115382449187Baptist Health LexingtonBaptist HealthAetnaPPO20255468.637118.997119.367120.297131.18127.7076503.817379.071.094640.964805
32711538244918510Baptist Health LexingtonBaptist HealthHumanaPPO202555787261.377261.757262.727273.81131.3066503.817379.071.116540.984101
6857510Memorial Hermann Cypress HospitalMemorial Hermann Health SystemHumanaPPO20248424.048424.058424.058424.058424.060.0023827706623.73inf1.2718
685415583318017Memorial Hermann the WoodlandsMemorial Hermann Health SystemAetnaPPO20247060.237060.247060.247060.247060.250.002413276635.8210783.21.063960.654742
6857522Memorial Hermann Cypress HospitalMemorial Hermann Health SystemKaiser PermanentePPO20248424.048424.058424.058424.058424.060.0023827706623.73inf1.2718
68577Memorial Hermann Cypress HospitalMemorial Hermann Health SystemAetnaPPO20248424.048424.058424.058424.058424.060.0023827706623.73inf1.2718
6857643Memorial Hermann Cypress HospitalMemorial Hermann Health SystemUnited HealthcarePPO20248424.048424.058958.269266.469266.47421.47706623.73inf1.35245
32711538244918643Baptist Health LexingtonBaptist HealthUnited HealthcarePPO20255468.637118.997119.367120.317131.18127.7076503.817379.071.094640.964805
68541558331801643Memorial Hermann the WoodlandsMemorial Hermann Health SystemUnited HealthcarePPO20247060.237060.247393.27766.267766.27353.1696635.8210783.21.114140.68562
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