Verda Health Plan

What does Verda Health Plan actually pay hospitals? We analyzed 82 negotiated rates from 3 hospitals across 1 states.

$25,322
Avg Negotiated Rate
82
Total Rates
44
Procedures Covered
3
Hospitals in Network
1
States

Is Verda Health Plan Expensive or Cheap?

Avg Rate
$25,322
Range: $10 - $231,090
vs All Payers Average
+150%
All-payer avg: $10,146
vs Medicare
1.7x Medicare
Medicare avg: $15,331

Based on our analysis of 82 negotiated rates, Verda Health Plan is significantly more expensive than average compared to other insurance companies in our database. They pay roughly 1.7x what Medicare pays for equivalent services.

Top Procedures with Negotiated Rates

Procedures where Verda Health Plan has the most rate data

Code Description Rates Avg Rate Min Max
36415 Collection of venous blood by venipuncture 3 $12 $12 $12
97530 Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes 3 $42 $40 $46
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 3 $117 $112 $128
293 HEART FAILURE AND SHOCK WITHOUT CC/MCC 3 $6,933 $6,352 $7,352
812 RED BLOOD CELL DISORDERS WITHOUT MCC 3 $9,824 $9,235 $10,179
689 KIDNEY AND URINARY TRACT INFECTIONS WITH MCC 3 $11,812 $11,217 $12,121
461 BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC 3 $47,628 $46,925 $48,829
003 ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH 3 $176,535 $173,132 $181,030
85025 Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count 2 $10 $10 $10
97140 Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes 2 $34 $32 $36
97110 Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility 2 $36 $33 $38
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 2 $40 $38 $43
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 2 $120 $112 $128
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 2 $128 $128 $128
897 ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC IPF 2 $5,370 $978 $9,762
641 MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOU 2 $8,485 $8,089 $8,881
292 HEART FAILURE AND SHOCK WITH CC 2 $9,146 $8,669 $9,623
561 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC 2 $9,179 $9,097 $9,261
190 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC 2 $11,243 $10,786 $11,699
560 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC 2 $11,392 $10,937 $11,847
291 HEART FAILURE AND SHOCK WITH MCC 2 $12,670 $12,227 $13,112
811 RED BLOOD CELL DISORDERS WITH MCC 2 $13,647 $13,214 $14,079
064 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC 2 $18,720 $18,179 $19,260
22612 Arthrodesis, posterior or posterolateral technique, single interspace; lumbar (with lateral transverse technique, when performed) (with cervical/without cervical) 2 $19,500 $19,500 $19,500
493 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC 2 $23,079 $22,477 $23,681

Hospitals with Verda Health Plan Rates

Hospitals where we have negotiated rate data for Verda Health Plan

Hospital State Rates Procedures Avg Rate Range
HCA HOUSTON HEALTHCARE MEDICAL CENTER TX 33 33 $26,111 $10 - $231,090
HCA HOUSTON HEALTHCARE TOMBALL TX 28 28 $29,143 $10 - $227,688
HCA HOUSTON HEALTHCARE CLEAR LAKE TX 21 21 $18,989 $12 - $181,030

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.

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