Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
L716910 SELEN ICP/MS
Key West, FL
See all hospitals reporting CPT 84255 →Price type
Key West HMA LLC’s median price of $25 is 32% below the median hospital's median price ($37), higher than 9% of the 2,434 hospitals reporting CPT 84255. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 11 payers, 27 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Humana humana medicaid fl facility · fee schedule · outpatient | $10 | $10 | — | — | — | $10 – $10 |
| 2 | WellCare healthease medicaid fl facility · fee schedule · outpatient | $10 | $10 | — | — | — | $10 – $10 |
| 3 | WellCare wellcare kids medicaid fl facility · fee schedule · outpatient | $10 | $10 | — | — | — | $10 – $10 |
| 4 | WellCare wellcare medicaid fl facility · fee schedule · outpatient | $10 | $10 | — | — | — | $10 – $10 |
| 5 | Molina molina medicaid fl facility · other · outpatient | $10 | $10 | — | — | — | $10 – $10 |
| 6 | Magellan magellan medicaid fl facility · fee schedule · outpatient | $11 | $11 | — | — | — | $11 – $11 |
| 7 | Bcbs Fl bcbs fl chs employee facility · percent of total billed charges · inpatientfrom % of charges | $12 | $12 | — | — | — | $12 – $12 |
| 8 | UnitedHealthcare uhc medicaid fl facility · fee schedule · outpatient | $20 | $20 | — | — | — | $20 – $20 |
| 9 | Cigna cigna all facility · percent of total billed charges · inpatientfrom % of charges | $20 | $20 | — | — | — | $20 – $20 |
| 10 | Cigna cigna all facility · percent of total billed charges · outpatientfrom % of charges | $20 | $20 | — | — | — | $20 – $20 |
| 11 | UnitedHealthcare uhc kids medicaid fl facility · fee schedule · outpatient | $21 | $21 | — | — | — | $21 – $21 |
| 12 | Bcbs Fl bcbs fl chs employee facility · percent of total billed charges · outpatientfrom % of charges | $22 | $22 | — | — | — | $22 – $22 |
| 13 | Aetna aetna all facility · percent of total billed charges · inpatientfrom % of charges | $24 | $24 | — | — | — | $24 – $24 |
| 14 | Aetna aetna all facility · percent of total billed charges · outpatientfrom % of charges | $24 | $24 | — | — | — | $24 – $24 |
| 15 | Tricare node tricare facility · fee schedule · outpatient | $25 | $25 | — | — | — | $25 – $25 |
| 16 | Bcbs Fl node bcbs fl mcr adv facility · fee schedule · outpatient | $25 | $25 | — | — | — | $25 – $25 |
| 17 | Humana node humana mcr adv facility · fee schedule · outpatient | $25 | $25 | — | — | — | $25 – $25 |
| 18 | Optum node united optum va ccn facility · fee schedule · outpatient | $26 | $26 | — | — | — | $26 – $26 |
| 19 | UnitedHealthcare uhc apa facility · percent of total billed charges · inpatientfrom % of charges | $27 | $27 | — | — | — | $27 – $27 |
| 20 | UnitedHealthcare uhc apa facility · percent of total billed charges · outpatientfrom % of charges | $27 | $27 | — | — | — | $27 – $27 |
| 21 | Bcbs Fl bcbs fl bsl facility · per diem · outpatient | $35 | $35 | — | — | — | $35 – $35 |
| 22 | Bcbs Fl bcbs fl hmo facility · per diem · outpatient | $35 | $35 | — | — | — | $35 – $35 |
| 23 | Bcbs Fl bcbs fl mbn facility · per diem · outpatient | $35 | $35 | — | — | — | $35 – $35 |
| 24 | Bcbs Fl bcbs fl nwb facility · per diem · outpatient | $35 | $35 | — | — | — | $35 – $35 |
| 25 | Bcbs Fl bcbs fl phs facility · per diem · outpatient | $35 | $35 | — | — | — | $35 – $35 |
Last updated: Apr 1, 2026
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