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 VI
Troy, PA
See all hospitals reporting CPT 0755T →Price type
Troy Community Hospital Incorporated’s median price of $226 is 218% above the median hospital's median price ($71), higher than 66% of the 545 hospitals reporting CPT 0755T. 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 | $81.27 | $81.27 | $81.27 – $81.27 |
| 2 | Tricare medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $81.27 | $81.27 | $81.27 – $81.27 |
| 3 | UnitedHealthcare medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $81.27 | $81.27 | $81.27 – $81.27 |
| 4 | Humana medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $84.11 | $84.11 | $84.11 – $84.11 |
| 5 | Blue Cross Blue Shield blue medicare hmo/ppo facility · percent of total billed charges · outpatientfrom % of charges | $89.40 | $89.40 | $89.40 – $89.40 |
| 6 | Blue Cross Blue Shield medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $89.40 | $89.40 | $89.40 – $89.40 |
| 7 | Blue Cross Blue Shield highmark wholecare medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $94.82 | $94.82 | $94.82 – $94.82 |
| 8 | WellCare medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $94.82 | $94.82 | $94.82 – $94.82 |
| 9 | WellCare fidelis medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $153.51 | $153.51 | $153.51 – $153.51 |
| 10 | Blue Cross Blue Shield managed medicaid facility · percent of total billed charges · bothfrom % of charges | $225.75 | $225.75 | $225.75 – $225.75 |
| 11 | Blue Cross Blue Shield managed medicaid facility · percent of total billed charges · outpatientfrom % of charges | $225.75 | $225.75 | $225.75 – $225.75 |
| 12 | Blue Cross Blue Shield highmark facility · percent of total billed charges · bothfrom % of charges | $254.10 | $254.10 | $254.10 – $254.10 |
| 13 | Blue Cross Blue Shield highmark facility · percent of total billed charges · outpatientfrom % of charges | $254.10 | $254.10 | $254.10 – $254.10 |
| 14 | Blue Cross Blue Shield highmark indemnity facility · percent of total billed charges · bothfrom % of charges | $254.10 | $254.10 | $254.10 – $254.10 |
| 15 | Blue Cross Blue Shield highmark indemnity facility · percent of total billed charges · outpatientfrom % of charges | $254.10 | $254.10 | $254.10 – $254.10 |
| 16 | Blue Cross Blue Shield highmark ppo facility · percent of total billed charges · bothfrom % of charges | $254.10 | $254.10 | $254.10 – $254.10 |
| 17 | Blue Cross Blue Shield highmark ppo facility · percent of total billed charges · outpatientfrom % of charges | $254.10 | $254.10 | $254.10 – $254.10 |
| 18 | Blue Cross Blue Shield first priority facility · percent of total billed charges · bothfrom % of charges | $284.31 | $284.31 | $284.31 – $284.31 |
| 19 | Blue Cross Blue Shield first priority facility · percent of total billed charges · outpatientfrom % of charges | $284.31 | $284.31 | $284.31 – $284.31 |
| 20 | UnitedHealthcare empire facility · percent of total billed charges · outpatientfrom % of charges | $327.79 | $327.79 | $327.79 – $327.79 |
| 21 | UnitedHealthcare student facility · percent of total billed charges · outpatientfrom % of charges | $327.79 | $327.79 | $327.79 – $327.79 |
| 22 | UnitedHealthcare managed medicaid facility · other · outpatient | $451.50 | $451.50 | $451.50 – $451.50 |
| 23 | WellCare managed medicaid facility · other · outpatient | $451.50 | $451.50 | $451.50 – $451.50 |
Last updated: Mar 31, 2026
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