▸ Payer

carelon

Negotiated rates published by hospitals for carelon across 3 states. Data sourced from federally-mandated machine-readable files.

Hospitals

Procedures

104

States

Rate rows

6,192

Median neg. rate

$84.8

Top procedures for carelon

By number of hospitals reporting rates for this payer.

Procedure	Type	Code	Hospitals	Avg rate
Psychotherapy 60 minutes	CPT	90837	15	$117.41
Office visit, new patient, 15-29 min	CPT	99202	15	$98.83
Office visit, new patient, 45-59 min	CPT	99204	15	$121.68
Office visit, new patient, 60-74 min	CPT	99205	15	$134.53
Office visit, established patient, 5 min	CPT	99211	15	$48.18
Office visit, established patient, 10-19 min	CPT	99212	15	$75.31
Office visit, established patient, 40-54 min	CPT	99215	15	$103.22
Office visit, established patient, 20-29 minutes	CPT	99213	15	$83.32
Office visit, established patient, 30-39 minutes	CPT	99214	15	$92.64
Psychiatric diagnostic evaluation	CPT	90791	15	$79.08
Office visit, new patient, 30-44 minutes	CPT	99203	15	$111.08
Psychotherapy 30 minutes	CPT	90832	15	$46.05
Psychotherapy 45 minutes	CPT	90834	15	$93.91
Psychiatric eval with medical services	CPT	90792	11	$170.98
Lumbosacral spine X-ray	CPT	72100	4	$315.62
Sigmoidoscopy diagnostic	CPT	45330	4	$1,382.88
MRI chest with contrast	CPT	71551	4	$1,744.51
MRI brain with and without contrast	CPT	70553	4	$2,458.74
MRI lumbar spine without contrast	CPT	72148	4	$1,728.6
Colonoscopy with biopsy	CPT	45380	4	$2,491.42
Colonoscopy with polyp removal	CPT	45385	4	$2,132.8
MRI brain with contrast	CPT	70552	4	$2,179.67
MRI brain without contrast	CPT	70551	4	$1,751.39
MRI chest with and without contrast	CPT	71552	4	$2,458.74
MRI cervical spine without contrast	CPT	72141	4	$1,940.16
MRI thoracic spine without contrast	CPT	72146	4	$1,968.54
CT cervical spine without contrast	CPT	72125	4	$1,997.35
CT thoracic spine without contrast	CPT	72128	4	$1,820.19
CT lumbar spine without contrast	CPT	72131	4	$1,815.03
Chest X-ray single view	CPT	71045	4	$294.55

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Top 20 cheapest hospitals for carelon

Lowest average negotiated rate across all procedures at this payer.

Hospital	City	ST	Avg neg. rate
ALLEGHENY VALLEY HOSPITAL	—	—	$93.17
ALLEGHENY GENERAL HOSPITAL	—	—	$93.17
SAINT VINCENT HOSPITAL	—	—	$93.17
JEFFERSON HOSPITAL	—	—	$93.17
Westfield Memorial Hospital	Westfield	NY	$93.17
WEST PENN HOSPITAL	—	—	$93.17
Drew Memorial Hospital Inc	Monticello	AR	$93.17
GROVE CITY HOSPITAL	—	—	$93.17
AHN WEXFORD HOSPITAL	—	—	$93.17
CANONSBURG HOSPITAL	—	—	$93.17
FORBES HOSPITAL	—	—	$93.17
Children's Medical Center of Dallas	—	—	$1,570.57
Children's Medical Center of Plano	—	—	$1,570.57
Childrens Medical Center Of Plano	Plano	TX	$1,570.57
Children's Medical Center Dallas	—	—	$1,570.57

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States covered

States with hospitals publishing rates for carelon.

State	Hospitals	Avg rate
AR	1	$93.17
NY	1	$93.17
TX	1	$1,570.57

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