▸ Payer

qualcare

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

Hospitals

Procedures

154

States

Rate rows

1,190

Median neg. rate

$6,324

Top procedures for qualcare

By number of hospitals reporting rates for this payer.

Procedure	Type	Code	Hospitals	Avg rate
OR procedure for obesity w CC	MS-DRG	620	16	$47,077
OR procedure for obesity w/o CC/MCC	MS-DRG	621	16	$45,102
OR procedure for obesity w MCC	MS-DRG	619	16	$54,516
Psychoses	MS-DRG	885	14	$10,198
Hip & femur procedures except major joint w/o CC/MCC	MS-DRG	482	5	$39,549
Major joint replacement w MCC	MS-DRG	469	5	$69,698
Hip & femur procedures except major joint w CC	MS-DRG	481	5	$45,966
Major joint replacement w/o MCC	MS-DRG	470	5	$47,815
MRI lower extremity joint without contrast	CPT	73721	4	$10,428
CT abdomen and pelvis without contrast	CPT	74176	4	$3,340.57
Office visit, established patient, 30-39 minutes	CPT	99214	4	$418.77
Office visit, established patient, 20-29 minutes	CPT	99213	4	$324.49
Office visit, new patient, 30-44 minutes	CPT	99203	4	$368.94
Comprehensive metabolic panel	CPT	80053	4	$349.64
Lipid panel	CPT	80061	4	$204.57
Complete blood count with automated differential	CPT	85025	4	$252.99
MRI brain without contrast	CPT	70551	4	$5,803.11
MRI brain with and without contrast	CPT	70553	4	$10,965
MRI lumbar spine without contrast	CPT	72148	4	$5,904.15
Laparoscopic cholecystectomy w/o CDE w/o CC/MCC	MS-DRG	420	3	$109,930
Heart failure & shock w/o CC/MCC	MS-DRG	293	3	$20,230
Cardiac arrhythmia w MCC	MS-DRG	308	3	$36,484
Cardiac arrhythmia w CC	MS-DRG	309	3	$23,575
Cardiac arrhythmia w/o CC/MCC	MS-DRG	310	3	$16,840
AMI discharged alive w MCC	MS-DRG	280	3	$50,961
Simple pneumonia & pleurisy w/o CC/MCC	MS-DRG	195	3	$21,353
Respiratory infections & inflammations w MCC	MS-DRG	177	3	$57,152
COPD w CC	MS-DRG	191	3	$27,989
Hip & femur procedures except major joint w MCC	MS-DRG	480	3	$90,054
Laparoscopic cholecystectomy w/o CDE w CC	MS-DRG	419	3	$37,655

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Top 20 cheapest hospitals for qualcare

Lowest average negotiated rate across all procedures at this payer.

Hospital	City	ST	Avg neg. rate
The Childrens Hospital Of Philadelp	Philadelphia	PA	$1,901.88
Children's Hospital Of Philadelphia Transplant	—	—	$2,396.78
American Oncologic Hospial	Philadelphia	PA	$3,121.84
Fox Chase Cancer Center	—	—	$3,121.84
Perth Amboy Medical Center	—	—	$28,455
Old Bridge Medical Center	—	—	$28,455
Riverview Medical Center	—	—	$33,173
Bayshore Medical Center	Holmdel	NJ	$33,173
Raritan Bay Medical Center	Perth Amboy	NJ	$33,173
Riverview Medical Center	Red Bank	NJ	$33,173
Bayshore Medical Center	—	—	$33,173
Ocean University Medical Center	—	—	$33,173
Hmh -Ocean Medical Center	Brick	NJ	$33,173
Jersey Shore University Med Ctr	Neptune	NJ	$33,187
Southern Ocean Medical Center	—	—	$43,788
Southern Ocean Medical Center	Manahawkin	NJ	$43,788
Hackensack University Medical Center	—	—	$46,560
Jfk University Medical Center	Edison	NJ	$46,560
Hackensack University Medical Center	Hackensack	NJ	$46,560
JFK University Medical Center	—	—	$46,603

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States covered

States with hospitals publishing rates for qualcare.

State	Hospitals	Avg rate
NJ	8	$44,621
PA	2	$3,064.14

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