TriWest Health Alliance
What does TriWest Health Alliance actually pay hospitals? We analyzed 190 negotiated rates from 5 hospitals across 2 states.
$19,592
Avg Negotiated Rate
190
Total Rates
52
Procedures Covered
5
Hospitals in Network
2
States
Is TriWest Health Alliance Expensive or Cheap?
Avg Rate
$19,592
Range: $8 - $235,529
vs All Payers Average
+93%
All-payer avg: $10,146
vs Medicare
1.3x Medicare
Medicare avg: $15,331
Based on our analysis of 190 negotiated rates, TriWest Health Alliance is significantly more expensive than average compared to other insurance companies in our database. They pay roughly 1.3x what Medicare pays for equivalent services.
Top Procedures with Negotiated Rates
Procedures where TriWest Health Alliance has the most rate data
| Code | Description | Rates | Avg Rate | Min | Max |
|---|---|---|---|---|---|
| 36415 | Collection of venous blood by venipuncture | 8 | $9 | $9 | $9 |
| 97530 | Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes | 7 | $33 | $31 | $35 |
| 85025 | Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count | 6 | $8 | $8 | $8 |
| 97110 | Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility | 6 | $28 | $26 | $29 |
| 97112 | Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing act | 6 | $32 | $29 | $34 |
| 97162 | Physical therapy evaluation: moderate complexity, requiring these components: A history of present problem with 1-2 personal factors and/or comorbidities that impact the plan of care; An examination o | 6 | $91 | $86 | $99 |
| 97161 | Physical therapy evaluation: low complexity, requiring these components: A history with no personal factors and/or comorbidities that impact the plan of care; An examination of body system(s) using st | 6 | $98 | $86 | $101 |
| 97163 | Physical therapy evaluation: high complexity, requiring these components: A history of present problem with 3 or more personal factors and/or comorbidities that impact the plan of care; An examination | 6 | $98 | $89 | $101 |
| 97140 | Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes | 5 | $27 | $25 | $29 |
| 293 | HEART FAILURE AND SHOCK WITHOUT CC/MCC | 5 | $6,104 | $5,659 | $6,684 |
| 812 | RED BLOOD CELL DISORDERS WITHOUT MCC | 5 | $8,853 | $8,396 | $9,253 |
| 461 | BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC | 5 | $44,798 | $42,659 | $47,399 |
| 003 | ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH | 5 | $167,367 | $157,393 | $178,685 |
| 897 | ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC IPF | 4 | $6,693 | $1,013 | $8,874 |
| 641 | MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOU | 4 | $7,643 | $7,354 | $8,074 |
| 561 | AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC | 4 | $8,065 | $7,628 | $8,420 |
| 292 | HEART FAILURE AND SHOCK WITH CC | 4 | $8,238 | $7,881 | $8,749 |
| 190 | CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC | 4 | $10,267 | $9,806 | $10,636 |
| 560 | AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC | 4 | $10,411 | $9,942 | $10,770 |
| 689 | KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | 4 | $10,698 | $10,197 | $11,019 |
| 291 | HEART FAILURE AND SHOCK WITH MCC | 4 | $11,648 | $11,116 | $11,956 |
| 811 | RED BLOOD CELL DISORDERS WITH MCC | 4 | $12,593 | $12,012 | $12,963 |
| 064 | INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC | 4 | $17,423 | $16,527 | $18,036 |
| 493 | LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC | 4 | $21,589 | $20,434 | $22,426 |
| 480 | HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC | 4 | $24,422 | $23,233 | $25,571 |
Hospitals with TriWest Health Alliance Rates
Hospitals where we have negotiated rate data for TriWest Health Alliance
| Hospital | State | Rates | Procedures | Avg Rate | Range |
|---|---|---|---|---|---|
| HCA HEALTHONE PRESBYTERIAN ST LUKES | CO | 49 | 49 | $19,892 | $8 - $232,973 |
| HCA HEALTHONE AURORA | CO | 44 | 44 | $20,928 | $8 - $235,529 |
| HCA HOUSTON HEALTHCARE MEDICAL CENTER | TX | 37 | 31 | $20,122 | $8 - $210,082 |
| HCA HOUSTON HEALTHCARE TOMBALL | TX | 34 | 28 | $21,166 | $8 - $206,989 |
| HCA HOUSTON HEALTHCARE CLEAR LAKE | TX | 26 | 21 | $13,950 | $9 - $164,572 |
About This Data
These rates are from hospital Machine-Readable Files (MRFs) required by the CMS Hospital Price Transparency Rule. They reflect specific hospital-payer contracts and may not represent your actual cost, which depends on your specific plan, deductible, copay, coinsurance, and network status. Data sources include CommonSpirit Health, HCA Healthcare, and Kaiser Permanente filings.