What this sample shows: A real hospital pricing comparison using published data — the kind of report brokers use in renewal meetings, proposals, and client conversations to demonstrate cost visibility and steerage savings.
Prepared for: [Broker Name / Agency]
Market: Austin, TX Metro (8 hospitals compared)
Procedures: Total Knee Replacement, Total Hip Replacement, Knee Arthroscopy, ER Visits
| Payer | Highest Hospital | Rate | Lowest Hospital | Rate | Savings/Case |
|---|---|---|---|---|---|
| UHC | Dell Seton | $14,112 | Seton Williamson | $1,894 | $12,218 |
| Aetna Whole Health | Dell Seton | $12,401 | Seton Hays | $1,902 | $10,500 |
| Humana HMO | Seton Smithville | $32,093 | Dell Seton | $20,564 | $11,529 |
| Humana PPO | Seton Highland Lakes | $32,093 | Dell Seton | $23,123 | $8,970 |
| BCBS Preferred | Dell Seton | $9,470 | Seton Williamson | $7,420 | $2,050 |
| Payer | Highest | Rate | Lowest | Rate | Savings |
|---|---|---|---|---|---|
| Cigna HMO | Seton Northwest | $27,040 | Dell Seton | $8,044 | $18,996 |
| Cigna PPO | Seton Williamson | $27,040 | Dell Seton | $10,329 | $16,711 |
| Group Size | Est. Knee Cases/yr | Current Cost (High) | Steered Cost (Low) | Annual Savings |
|---|---|---|---|---|
| 100 lives | 1 | $14,112 | $1,894 | $12,218 |
| 500 lives | 2 | $28,224 | $3,788 | $24,436 |
| 1,000 lives | 4 | $56,447 | $7,576 | $48,871 |
| 2,500 lives | 10 | $141,118 | $18,940 | $122,178 |
"Your employees are going to these hospitals for knee surgery. Here's what the plan is actually paying at each one — and where we can save $12K per case by steering to an in-network alternative."
"We analyzed every hospital in your employees' metro area. Here are the pricing gaps we found. We can show this for any procedure, any payer."
"Here's something your current broker probably hasn't shown you — the actual negotiated rates at the hospitals your employees use."
All rates sourced from CMS Hospital Price Transparency Machine-Readable Files (45 CFR 180). Data refreshed weekly. 2,000+ hospitals tracked across TX, FL, NY, CA, IL, OH, PA, NJ, NC, VA. 1.2 billion+ negotiated rate records.
| Data Source | CMS Hospital Price Transparency Machine-Readable Files (45 CFR 180) |
| Comparison Basis | Same CPT code, same payer, across all hospitals in the Austin metro area |
| Data Freshness | Hospital files monitored daily. Rates reflect most recent available filing. |
| Limitations | Negotiated rates may not reflect final member cost. Some hospitals may not publish all contracts. Savings estimates assume steerage to lowest-cost in-network option. |
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