▸ Payer

fallon carelon hlth [28]

Negotiated rates published by hospitals for fallon carelon hlth [28] across 2 states. Data sourced from federally-mandated machine-readable files.

Hospitals

Procedures

146

States

Rate rows

644

Median neg. rate

$1,252.6

Top procedures for fallon carelon hlth [28]

By number of hospitals reporting rates for this payer.

Procedure	Type	Code	Hospitals	Avg rate
Colonoscopy diagnostic	CPT	45378	6	$3,657.5
Colonoscopy with biopsy	CPT	45380	6	$3,657.5
Upper GI endoscopy diagnostic	CPT	43235	6	$2,502
Upper GI endoscopy with biopsy	CPT	43239	6	$2,890
Sigmoidoscopy diagnostic	CPT	45330	6	$1,850
Sigmoidoscopy with biopsy	CPT	45331	6	$1,850
Heart failure & shock w MCC	MS-DRG	291	6	$1,637.86
Heart failure & shock w CC	MS-DRG	292	6	$1,637.86
Esophagitis/gastroenteritis w/o MCC	MS-DRG	392	6	$1,637.86
Cardiac arrhythmia w MCC	MS-DRG	308	6	$1,637.86
Cardiac arrhythmia w CC	MS-DRG	309	6	$1,637.86
Cardiac arrhythmia w/o CC/MCC	MS-DRG	310	6	$1,637.86
AMI discharged alive w MCC	MS-DRG	280	6	$1,637.86
AMI discharged alive w CC	MS-DRG	281	6	$1,637.86
AMI discharged alive w/o CC/MCC	MS-DRG	282	6	$1,637.86
Intracranial hemorrhage/CVA w MCC	MS-DRG	064	6	$1,637.86
Intracranial hemorrhage/CVA w CC	MS-DRG	065	6	$1,637.86
Intracranial hemorrhage/CVA w/o CC/MCC	MS-DRG	066	6	$1,637.86
Simple pneumonia & pleurisy w CC	MS-DRG	194	6	$1,637.86
Simple pneumonia & pleurisy w/o CC/MCC	MS-DRG	195	6	$1,637.86
Respiratory infections & inflammations w MCC	MS-DRG	177	6	$1,637.86
COPD w MCC	MS-DRG	190	6	$1,637.86
COPD w CC	MS-DRG	191	6	$1,637.86
COPD w/o CC/MCC	MS-DRG	192	6	$1,637.86
GI hemorrhage w CC	MS-DRG	378	6	$1,637.86
Major small/large bowel procedures w MCC	MS-DRG	329	6	$1,637.86
Major small/large bowel procedures w CC	MS-DRG	330	6	$1,637.86
Major small/large bowel procedures w/o CC/MCC	MS-DRG	331	6	$1,637.86
Laparoscopic cholecystectomy w/o CDE w MCC	MS-DRG	418	6	$1,637.86
Laparoscopic cholecystectomy w/o CDE w CC	MS-DRG	419	6	$1,637.86

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Lowest average negotiated rate across all procedures at this payer.

Hospital	City	ST	Avg neg. rate
Webster County Memorial Hospital	Webster Springs	WV	$1,453.91
UMass Memorial Health-Harrington Hospital	—	—	$1,453.91
Harrington Memorial Hospital	Southbridge	MA	$1,453.91
HealthAlliance-Clinton, Leominster Campus	—	—	$1,695.6
HealthAlliance-Clinton, Clinton Campus	—	—	$1,695.6
Healthalliance-Clinton	Leominster	MA	$1,695.6

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States with hospitals publishing rates for fallon carelon hlth [28].

State	Hospitals	Avg rate
MA	2	$1,579.26
WV	1	$1,453.91

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