Where to Negotiate
Gap Analysis
Every (CPT, payer) pair where your hospital has data, ranked by estimated annual revenue impact at the volume you choose.
87
Contract lines
all payers
14
Below median
upside opportunities
67
Above median
defend in renewal
$424.1K
Total leverage
at default 100/yr volume
All payersAetnaBlue Cross Blue ShieldCignaFirst HealthGalaxy Health NetworkHealth's Finest NetworkHealthLinkHumanaImagine HealthMultiplanUnitedHealthcare
87 contract lines · sorted by
| CPT | Procedure | Payer | Your rate | Market median | Gap / proc | Volume | Annual impact | Tier | Action |
|---|---|---|---|---|---|---|---|---|---|
| 43239 | HB Egd Transoral Biopsy Single/Multiple | HealthLink | $4,597 | $5,681 | +$1,084(-19.1%) | $108.4K | Watch | ||
| 74177 | HB CT Abd & Pelv W/Contrast | Imagine Health | $2,333 | $2,981 | +$648(-21.7%) | $64.8K | Hot | ||
| 70553 | HB MRI Brain Stem W/O & W/Dye | Imagine Health | $2,077 | $2,654 | +$577(-21.7%) | $57.7K | Hot | ||
| 43239 | HB Egd Transoral Biopsy Single/Multiple | Multiplan | $7,500 | $7,957 | +$457(-5.7%) | $45.7K | Defend | ||
| 70551 | HB MRI Brain Stem W/O Dye | Imagine Health | $1,499 | $1,916 | +$416(-21.7%) | $41.6K | Hot | ||
| 71250 | HB CT Thorax, Diagnostic W/O Dye | Imagine Health | $1,007 | $1,287 | +$280(-21.7%) | $28.0K | Hot | ||
| 29881 | HB Arthroscop Knee Med and Lat | HealthLink | $20,165 | $20,442 | +$278(-1.4%) | $27.8K | Defend | ||
| 99283 | HB ED Visit Level 3 | Humana | $1,001 | $1,154 | +$154(-13.3%) | $15.4K | Watch | ||
| 99284 | HB ED Visit Level 4 | Imagine Health | $1,268 | $1,391 | +$124(-8.9%) | $12.4K | Defend | ||
| 99283 | HB ED Visit Level 3 | Imagine Health | $597 | $703 | +$105(-15.0%) | $10.5K | Watch | ||
| 99283 | HB ED Visit Level 3 | Galaxy Health Network | $2,213 | $2,262 | +$49.63(-2.2%) | $5.0K | Defend | ||
| 99283 | HB ED Visit Level 3 | Aetna | $675 | $712 | +$36.74(-5.2%) | $3.7K | Defend | ||
| 70551 | HB MRI Brain Stem W/O Dye | Aetna | $1,583 | $1,613 | +$30.39(-1.9%) | $3.0K | Defend | ||
| 99284 | HB ED Visit Level 4 | Galaxy Health Network | $4,696 | $4,698 | +$1.75(-0.0%) | $175 | Defend | ||
| 99284 | HB ED Visit Level 4 | Humana | $2,314 | $2,314 | $0(0.0%) | $0 | Above | ||
| 29881 | HB Arthroscop Knee Med and Lat | Humana | $16,498 | $16,498 | $0(0.0%) | $0 | Above | ||
| 74177 | HB CT Abd & Pelv W/Contrast | Galaxy Health Network | $8,642 | $8,642 | $0(0.0%) | $0 | Above | ||
| 71250 | HB CT Thorax, Diagnostic W/O Dye | Galaxy Health Network | $3,730 | $3,730 | $0(0.0%) | $0 | Above | ||
| 70551 | HB MRI Brain Stem W/O Dye | Galaxy Health Network | $5,553 | $5,553 | $0(0.0%) | $0 | Above | ||
| 70553 | HB MRI Brain Stem W/O & W/Dye | Galaxy Health Network | $7,693 | $7,693 | $0(0.0%) | $0 | Above | ||
| 99283 | HB ED Visit Level 3 | Health's Finest Network | $1,631 | $1,608 | -$23(1.4%) | $-2.3K | Above | ||
| 43239 | HB Egd Transoral Biopsy Single/Multiple | UnitedHealthcare | $4,597 | $4,481 | -$116(2.6%) | $-11.6K | Above | ||
| 71250 | HB CT Thorax, Diagnostic W/O Dye | Aetna | $1,063 | $941 | -$122(13.0%) | $-12.2K | Above | ||
| 99284 | HB ED Visit Level 4 | Health's Finest Network | $3,413 | $3,214 | -$199(6.2%) | $-19.9K | Above | ||
| 43239 | HB Egd Transoral Biopsy Single/Multiple | Galaxy Health Network | $9,681 | $9,372 | -$309(3.3%) | $-30.9K | Above | ||
| 99283 | HB ED Visit Level 3 | Blue Cross Blue Shield | $1,126 | $792 | -$333(42.1%) | $-33.3K | Above | ||
| 43239 | HB Egd Transoral Biopsy Single/Multiple | Imagine Health | $2,614 | $2,272 | -$342(15.0%) | $-34.2K | Above | ||
| 99284 | HB ED Visit Level 4 | HealthLink | $3,607 | $3,251 | -$356(10.9%) | $-35.6K | Above | ||
| 99284 | HB ED Visit Level 4 | Aetna | $1,562 | $1,198 | -$364(30.4%) | $-36.4K | Above | ||
| 71250 | HB CT Thorax, Diagnostic W/O Dye | Health's Finest Network | $3,059 | $2,667 | -$392(14.7%) | $-39.2K | Above | ||
| 43239 | HB Egd Transoral Biopsy Single/Multiple | Health's Finest Network | $6,752 | $6,344 | -$408(6.4%) | $-40.8K | Above | ||
| 99283 | HB ED Visit Level 3 | First Health | $2,213 | $1,774 | -$439(24.7%) | $-43.9K | Above | ||
| 74177 | HB CT Abd & Pelv W/Contrast | Humana | $3,889 | $3,434 | -$455(13.3%) | $-45.5K | Above | ||
| 99283 | HB ED Visit Level 3 | HealthLink | $1,924 | $1,454 | -$470(32.3%) | $-47.0K | Above | ||
| 70553 | HB MRI Brain Stem W/O & W/Dye | Aetna | $2,193 | $1,613 | -$580(35.9%) | $-58.0K | Above | ||
| 70551 | HB MRI Brain Stem W/O Dye | Health's Finest Network | $4,553 | $3,970 | -$583(14.7%) | $-58.3K | Above | ||
| 71250 | HB CT Thorax, Diagnostic W/O Dye | First Health | $3,730 | $3,086 | -$644(20.9%) | $-64.4K | Above | ||
| 71250 | HB CT Thorax, Diagnostic W/O Dye | Humana | $1,679 | $981 | -$697(71.0%) | $-69.7K | Above | ||
| 99283 | HB ED Visit Level 3 | UnitedHealthcare | $2,213 | $1,501 | -$712(47.4%) | $-71.2K | Above | ||
| 99283 | HB ED Visit Level 3 | Cigna | $1,924 | $1,207 | -$717(59.4%) | $-71.7K | Above | ||
| 99283 | HB ED Visit Level 3 | Multiplan | $1,963 | $1,180 | -$782(66.3%) | $-78.2K | Above | ||
| 70553 | HB MRI Brain Stem W/O & W/Dye | Health's Finest Network | $6,308 | $5,500 | -$808(14.7%) | $-80.8K | Above | ||
| 99284 | HB ED Visit Level 4 | First Health | $4,696 | $3,883 | -$812(20.9%) | $-81.2K | Above | ||
| 71250 | HB CT Thorax, Diagnostic W/O Dye | Blue Cross Blue Shield | $1,865 | $1,046 | -$819(78.4%) | $-81.9K | Above | ||
| 70553 | HB MRI Brain Stem W/O & W/Dye | Humana | $3,462 | $2,640 | -$822(31.1%) | $-82.2K | Above | ||
| 74177 | HB CT Abd & Pelv W/Contrast | Health's Finest Network | $7,086 | $6,179 | -$907(14.7%) | $-90.7K | Above | ||
| 43239 | HB Egd Transoral Biopsy Single/Multiple | Cigna | $4,597 | $3,657 | -$940(25.7%) | $-94.0K | Above | ||
| 70551 | HB MRI Brain Stem W/O Dye | First Health | $5,553 | $4,594 | -$959(20.9%) | $-95.9K | Above | ||
| 70551 | HB MRI Brain Stem W/O Dye | Blue Cross Blue Shield | $2,777 | $1,750 | -$1,027(58.7%) | $-102.7K | Above | ||
| 70551 | HB MRI Brain Stem W/O Dye | Humana | $2,499 | $1,428 | -$1,071(75.0%) | $-107.1K | Above | ||
| 99284 | HB ED Visit Level 4 | UnitedHealthcare | $3,607 | $2,484 | -$1,123(45.2%) | $-112.3K | Above | ||
| 43239 | HB Egd Transoral Biopsy Single/Multiple | First Health | $9,681 | $8,507 | -$1,173(13.8%) | $-117.3K | Above | ||
| 99284 | HB ED Visit Level 4 | Blue Cross Blue Shield | $2,603 | $1,408 | -$1,195(84.9%) | $-119.5K | Above | ||
| 70553 | HB MRI Brain Stem W/O & W/Dye | First Health | $7,693 | $6,364 | -$1,329(20.9%) | $-132.9K | Above | ||
| 70553 | HB MRI Brain Stem W/O & W/Dye | Blue Cross Blue Shield | $3,847 | $2,480 | -$1,366(55.1%) | $-136.6K | Above | ||
| 71250 | HB CT Thorax, Diagnostic W/O Dye | Multiplan | $3,730 | $2,359 | -$1,371(58.1%) | $-137.1K | Above | ||
| 71250 | HB CT Thorax, Diagnostic W/O Dye | HealthLink | $3,730 | $2,350 | -$1,380(58.7%) | $-138.0K | Above | ||
| 99284 | HB ED Visit Level 4 | Cigna | $3,607 | $2,185 | -$1,422(65.1%) | $-142.2K | Above | ||
| 43239 | HB Egd Transoral Biopsy Single/Multiple | Aetna | $3,986 | $2,505 | -$1,481(59.1%) | $-148.1K | Above | ||
| 74177 | HB CT Abd & Pelv W/Contrast | First Health | $8,642 | $7,149 | -$1,493(20.9%) | $-149.3K | Above | ||
| 74177 | HB CT Abd & Pelv W/Contrast | Aetna | $2,463 | $941 | -$1,522(161.7%) | $-152.2K | Above | ||
| 70551 | HB MRI Brain Stem W/O Dye | HealthLink | $5,553 | $3,498 | -$2,055(58.7%) | $-205.5K | Above | ||
| 99284 | HB ED Visit Level 4 | Multiplan | $4,117 | $2,043 | -$2,075(101.6%) | $-207.5K | Above | ||
| 29881 | HB Arthroscop Knee Med and Lat | Galaxy Health Network | $36,663 | $34,273 | -$2,389(7.0%) | $-238.9K | Above | ||
| 70551 | HB MRI Brain Stem W/O Dye | Multiplan | $5,553 | $2,971 | -$2,582(86.9%) | $-258.2K | Above | ||
| 74177 | HB CT Abd & Pelv W/Contrast | Blue Cross Blue Shield | $4,321 | $1,535 | -$2,786(181.6%) | $-278.6K | Above | ||
| 70553 | HB MRI Brain Stem W/O & W/Dye | HealthLink | $7,693 | $4,847 | -$2,846(58.7%) | $-284.6K | Above | ||
| 43239 | HB Egd Transoral Biopsy Single/Multiple | Humana | $5,906 | $2,980 | -$2,926(98.2%) | $-292.6K | Above | ||
| 71250 | HB CT Thorax, Diagnostic W/O Dye | UnitedHealthcare | $3,730 | $718 | -$3,012(419.5%) | $-301.2K | Above | ||
| 70553 | HB MRI Brain Stem W/O & W/Dye | Multiplan | $7,693 | $4,627 | -$3,067(66.3%) | $-306.6K | Above | ||
| 71250 | HB CT Thorax, Diagnostic W/O Dye | Cigna | $3,730 | $653 | -$3,077(471.2%) | $-307.7K | Above | ||
| 74177 | HB CT Abd & Pelv W/Contrast | HealthLink | $8,642 | $5,444 | -$3,198(58.7%) | $-319.8K | Above | ||
| 43239 | HB Egd Transoral Biopsy Single/Multiple | Blue Cross Blue Shield | $5,621 | $2,165 | -$3,456(159.6%) | $-345.6K | Above | ||
| 74177 | HB CT Abd & Pelv W/Contrast | Multiplan | $8,642 | $5,067 | -$3,576(70.6%) | $-357.6K | Above | ||
| 29881 | HB Arthroscop Knee Med and Lat | Health's Finest Network | $30,064 | $25,884 | -$4,180(16.1%) | $-418.0K | Above | ||
| 70551 | HB MRI Brain Stem W/O Dye | UnitedHealthcare | $5,553 | $1,276 | -$4,277(335.2%) | $-427.7K | Above | ||
| 70551 | HB MRI Brain Stem W/O Dye | Cigna | $5,553 | $1,096 | -$4,457(406.7%) | $-445.7K | Above | ||
| 29881 | HB Arthroscop Knee Med and Lat | Aetna | $10,999 | $4,843 | -$6,156(127.1%) | $-615.6K | Above | ||
| 70553 | HB MRI Brain Stem W/O & W/Dye | UnitedHealthcare | $7,693 | $1,276 | -$6,417(502.9%) | $-641.7K | Above | ||
| 70553 | HB MRI Brain Stem W/O & W/Dye | Cigna | $7,693 | $1,096 | -$6,597(601.9%) | $-659.7K | Above | ||
| 74177 | HB CT Abd & Pelv W/Contrast | UnitedHealthcare | $8,642 | $911 | -$7,731(848.4%) | $-773.1K | Above | ||
| 74177 | HB CT Abd & Pelv W/Contrast | Cigna | $8,642 | $653 | -$7,989(1223.4%) | $-798.9K | Above | ||
| 29881 | HB Arthroscop Knee Med and Lat | Multiplan | $36,663 | $28,152 | -$8,511(30.2%) | $-851.1K | Above | ||
| 29881 | HB Arthroscop Knee Med and Lat | First Health | $36,663 | $25,479 | -$11,184(43.9%) | $-1.1M | Above | ||
| 29881 | HB Arthroscop Knee Med and Lat | Blue Cross Blue Shield | $18,331 | $3,854 | -$14,477(375.6%) | $-1.4M | Above | ||
| 29881 | HB Arthroscop Knee Med and Lat | Cigna | $36,663 | $15,147 | -$21,516(142.1%) | $-2.2M | Above | ||
| 29881 | HB Arthroscop Knee Med and Lat | UnitedHealthcare | $36,663 | $10,420 | -$26,243(251.9%) | $-2.6M | Above |