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Insurance Transparency Definitions and Methodology

Data are obtained on an ongoing basis for each insurer and the most recent MedPAR file. Since many MS-DRG payment rates are collected for each individual health plan, the Minimum, Average, Median, and Maximum payment rates are calculated and reported for all of an insurer's plans accepted at a hospital.

A hospital's average charge, payment, cost, and length of stay for each MS-DRG are calculated from Medicare claims and reported for comparison. A hospital's CMS wage index from its annual Impact File is also provided as a measure of relative labor cost.