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
Dgtz Gls Mcrscp Sld Level V
Troy, PA
See all hospitals reporting CPT 0754T →Price type
Troy Community Hospital Incorporated’s median price of $150 is 121% above the median hospital's median price ($68), higher than 64% of the 543 hospitals reporting CPT 0754T. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 6 payers, 23 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 | Aetna medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $54.14 | $54.14 | $54.14 – $54.14 |
| 2 | Tricare medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $54.14 | $54.14 | $54.14 – $54.14 |
| 3 | UnitedHealthcare medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $54.14 | $54.14 | $54.14 – $54.14 |
| 4 | Humana medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $56.03 | $56.03 | $56.03 – $56.03 |
| 5 | Blue Cross Blue Shield blue medicare hmo/ppo facility · percent of total billed charges · outpatientfrom % of charges | $59.55 | $59.55 | $59.55 – $59.55 |
| 6 | Blue Cross Blue Shield medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $59.55 | $59.55 | $59.55 – $59.55 |
| 7 | Blue Cross Blue Shield highmark wholecare medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $63.16 | $63.16 | $63.16 – $63.16 |
| 8 | WellCare medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $63.16 | $63.16 | $63.16 – $63.16 |
| 9 | WellCare fidelis medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $102.26 | $102.26 | $102.26 – $102.26 |
| 10 | Blue Cross Blue Shield managed medicaid facility · percent of total billed charges · bothfrom % of charges | $150.38 | $150.38 | $150.38 – $150.38 |
| 11 | Blue Cross Blue Shield managed medicaid facility · percent of total billed charges · outpatientfrom % of charges | $150.38 | $150.38 | $150.38 – $150.38 |
| 12 | Blue Cross Blue Shield highmark facility · percent of total billed charges · bothfrom % of charges | $169.26 | $169.26 | $169.26 – $169.26 |
| 13 | Blue Cross Blue Shield highmark facility · percent of total billed charges · outpatientfrom % of charges | $169.26 | $169.26 | $169.26 – $169.26 |
| 14 | Blue Cross Blue Shield highmark indemnity facility · percent of total billed charges · bothfrom % of charges | $169.26 | $169.26 | $169.26 – $169.26 |
| 15 | Blue Cross Blue Shield highmark indemnity facility · percent of total billed charges · outpatientfrom % of charges | $169.26 | $169.26 | $169.26 – $169.26 |
| 16 | Blue Cross Blue Shield highmark ppo facility · percent of total billed charges · bothfrom % of charges | $169.26 | $169.26 | $169.26 – $169.26 |
| 17 | Blue Cross Blue Shield highmark ppo facility · percent of total billed charges · outpatientfrom % of charges | $169.26 | $169.26 | $169.26 – $169.26 |
| 18 | Blue Cross Blue Shield first priority facility · percent of total billed charges · bothfrom % of charges | $189.38 | $189.38 | $189.38 – $189.38 |
| 19 | Blue Cross Blue Shield first priority facility · percent of total billed charges · outpatientfrom % of charges | $189.38 | $189.38 | $189.38 – $189.38 |
| 20 | UnitedHealthcare empire facility · percent of total billed charges · outpatientfrom % of charges | $218.34 | $218.34 | $218.34 – $218.34 |
| 21 | UnitedHealthcare student facility · percent of total billed charges · outpatientfrom % of charges | $218.34 | $218.34 | $218.34 – $218.34 |
| 22 | UnitedHealthcare managed medicaid facility · other · outpatient | $300.75 | $300.75 | $300.75 – $300.75 |
| 23 | WellCare managed medicaid facility · other · outpatient | $300.75 | $300.75 | $300.75 – $300.75 |
Last updated: Mar 31, 2026
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