▸ Payer

managed health services

Negotiated rates published by hospitals for managed health services across 2 states. Data sourced from federally-mandated machine-readable files.

Hospitals

Procedures

113

States

Rate rows

437

Median neg. rate

$6,757.16

Top procedures for managed health services

By number of hospitals reporting rates for this payer.

Procedure	Type	Code	Hospitals	Avg rate
Basic metabolic panel (BMP)	CPT	80048	6	$9.11
Comprehensive metabolic panel	CPT	80053	6	$11.37
Electrolyte panel	CPT	80051	6	$7.54
Renal function panel	CPT	80069	6	$9.34
Hepatic function panel	CPT	80076	6	$8.8
Urinalysis non-automated	CPT	81002	6	$3.74
Urinalysis automated	CPT	81003	6	$2.42
Glucose quantitative	CPT	82947	6	$4.23
Hemoglobin A1c	CPT	83036	6	$10.45
Thyroid stimulating hormone (TSH)	CPT	84443	6	$18.08
Lipid panel	CPT	80061	6	$14.42
Complete blood count with automated differential	CPT	85025	6	$8.36
ED visit level 1	CPT	99281	6	$34.19
Urine culture identification	CPT	87088	6	$8.71
Urine culture bacterial	CPT	87086	6	$8.69
Complete blood count without differential	CPT	85027	6	$6.96
Office visit, established patient, 20-29 minutes	CPT	99213	5	$65.25
Office visit, established patient, 30-39 minutes	CPT	99214	5	$92.43
Office visit, new patient, 30-44 minutes	CPT	99203	5	$80.33
Office visit, new patient, 15-29 min	CPT	99202	5	$52.22
Office visit, new patient, 45-59 min	CPT	99204	5	$119.82
Office visit, new patient, 60-74 min	CPT	99205	5	$158.12
Office visit, established patient, 5 min	CPT	99211	5	$16.86
Office visit, established patient, 10-19 min	CPT	99212	5	$40.81
Office visit, established patient, 40-54 min	CPT	99215	5	$129.57
General health panel	CPT	80050	5	$56.07
Tissue exam by pathologist level IV	CPT	88305	5	$71.42
Shoulder arthroscopy with rotator cuff repair	CPT	29827	2	$5,280.51
Upper GI endoscopy diagnostic	CPT	43235	2	$693.03
ACL reconstruction	CPT	29888	2	$5,280.51

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Lowest average negotiated rate across all procedures at this payer.

Hospital	City	ST	Avg neg. rate
Childrens Hospital Of Wisconsin	—	—	$38.56
Ssh - Fox Valley	Oshkosh	WI	$38.56
Children's Hospital of Wisconsin - Milwaukee	—	—	$38.56
Childrens Hospital Of Wi-Fox Valley	Neenah	WI	$38.56
Childrens Wisconsin	Milwaukee	WI	$38.56
Marshfield Medical Center Dickinson Hospital	—	—	$3,109.96
Beaver Dam Community Hospitals	Beaver Dam	WI	$6,159.43

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States with hospitals publishing rates for managed health services.

State	Hospitals	Avg rate
WI	4	$3,629.89

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