The hospitals that file a Premera rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.
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106 hospital rates
| # | Plans | |||
|---|---|---|---|---|
| 1 | COMMONSPIRIT OREGON Roseburg, OR fee schedule · inpatient | 1 | $839.28 | $839.28 – $839.28 |
| 2 | COMMONSPIRIT OREGON Roseburg, OR fee schedule · outpatient | 1 | $893.08 | $893.08 – $893.08 |
| 3 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · fee schedule · both | 1 | $106.81 | $106.81 – $106.81 |
| 4 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · inpatient | 1 | $128.20 | $38.20 – $218.20 |
| 5 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · outpatient | 1 | $128.20 | $38.20 – $218.20 |
| 6 | Catholic Health Initiatives-Iowa Corp West Des Moines, IA facility · fee schedule · both | 1 | $106.81 | $106.81 – $106.81 |
| 7 | Central Washington Health Services Association Wenatchee, WA other · both | 1 | $206.04 | $206.04 – $206.04 |
| 8 | Central Washington Health Services Association Wenatchee, WA other · outpatient | 1 | $206.04 | $206.04 – $206.04 |
| 9 | Central Washington Health Services Association Wenatchee, WA percent of total billed charges · bothfrom % of charges | 3 | $114.76 | $108.18 – $118.81 |
| 10 | Central Washington Health Services Association Wenatchee, WA percent of total billed charges · outpatientfrom % of charges | 3 | $504.79 | $475.84 – $522.58 |
| 11 | Clallam County Public Hospital District 2 DBA Olympic Medical Center Port Angeles, WA fee schedule · inpatient | 1 | $887.00 | $887.00 – $887.00 |
| 12 | Clallam County Public Hospital District 2 DBA Olympic Medical Center Port Angeles, WA fee schedule · outpatient | 1 | $887.00 | $887.00 – $887.00 |
| 13 | Columbia Lutheran Charities Astoria, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $935.75 | $935.75 – $935.75 |
| 14 | Coulee Medical Center Grand Coulee, WA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $673.21 | $673.21 – $673.21 |
| 15 | Covenant Medical Center Inc Waterloo, IA facility · fee schedule · both | 1 | $106.81 | $106.81 – $106.81 |
| 16 | Diley Ridge Medical Center Canal Winchester, OH facility · other · both | 1 | $376.03 | $376.03 – $376.03 |
| 17 | Good Samaritan Hospital Puyallup, WA fee schedule · outpatient | 4 | $379.37 | $200.22 – $504.81 |
| 18 | Holy Cross Germantown Hospital Germantown, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $656.32 | $656.32 – $656.32 |
| 19 | Holy Cross Germantown Hospital Germantown, MD professional · percent of total billed charges · bothfrom % of charges | 1 | $46.00 | $46.00 – $46.00 |
| 20 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · case rate · both | 1 | $788.00 | $788.00 – $788.00 |
| 21 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · case rate · outpatient | 1 | $788.00 | $788.00 – $788.00 |
| 22 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL professional · fee schedule · both | 1 | $132.74 | $132.74 – $132.74 |
| 23 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL professional · fee schedule · inpatient | 1 | $20.07 | $20.07 – $20.07 |
| 24 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL professional · fee schedule · outpatient | 1 | $201.22 | $201.22 – $201.22 |
| 25 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $690.31 | $690.31 – $690.31 |
← Payers reporting CPT 93971 · Snapshot 20261108T203506Z-bb90dbab