▸ Payer

wellpoint [11112]

Negotiated rates published by hospitals for wellpoint [11112] across 2 states. Data sourced from federally-mandated machine-readable files.

Hospitals

Procedures

164

States

Rate rows

1,683

Median neg. rate

$627.22

Top procedures for wellpoint [11112]

By number of hospitals reporting rates for this payer.

Procedure	Type	Code	Hospitals	Avg rate
Colonoscopy diagnostic	CPT	45378	10	$1,523.08
Colonoscopy with biopsy	CPT	45380	10	$1,523.08
Colonoscopy with polyp removal	CPT	45385	10	$1,523.08
Knee arthroscopy with meniscectomy	CPT	29881	10	$4,236.48
Shoulder arthroscopy with decompression	CPT	29826	10	$5,471.74
Upper GI endoscopy diagnostic	CPT	43235	10	$1,508.22
Upper GI endoscopy with biopsy	CPT	43239	10	$1,508.22
Sigmoidoscopy diagnostic	CPT	45330	10	$627.22
Sigmoidoscopy with biopsy	CPT	45331	10	$627.22
Shoulder arthroscopy with rotator cuff repair	CPT	29827	10	$5,471.74
ACL reconstruction	CPT	29888	10	$10,163
Laparoscopic appendectomy	CPT	44970	10	$4,794.24
Laparoscopic cholecystectomy	CPT	47562	10	$4,794.24
Heart failure & shock w MCC	MS-DRG	291	10	$10,141
Heart failure & shock w CC	MS-DRG	292	10	$8,672.71
Esophagitis/gastroenteritis w/o MCC	MS-DRG	392	10	$7,963.77
Cardiac arrhythmia w MCC	MS-DRG	308	10	$12,299
Cardiac arrhythmia w CC	MS-DRG	309	10	$7,515.33
Cardiac arrhythmia w/o CC/MCC	MS-DRG	310	10	$6,099.77
Intracranial hemorrhage/CVA w MCC	MS-DRG	064	10	$14,114
Intracranial hemorrhage/CVA w CC	MS-DRG	065	10	$10,320
Intracranial hemorrhage/CVA w/o CC/MCC	MS-DRG	066	10	$6,997.62
Simple pneumonia & pleurisy w CC	MS-DRG	194	10	$8,232.43
Simple pneumonia & pleurisy w/o CC/MCC	MS-DRG	195	10	$6,726.48
Respiratory infections & inflammations w MCC	MS-DRG	177	10	$15,963
COPD w MCC	MS-DRG	190	10	$11,315
COPD w CC	MS-DRG	191	10	$8,611.42
COPD w/o CC/MCC	MS-DRG	192	10	$6,558.16
GI hemorrhage w CC	MS-DRG	378	10	$10,018
Laparoscopic cholecystectomy w/o CDE w CC	MS-DRG	419	10	$12,169

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Lowest average negotiated rate across all procedures at this payer.

Hospital	City	ST	Avg neg. rate
Healthalliance-Clinton	Leominster	MA	$2,725.36
HealthAlliance-Clinton, Leominster Campus	—	—	$2,725.36
HealthAlliance-Clinton, Clinton Campus	—	—	$2,725.36
Harrington Memorial Hospital	Southbridge	MA	$2,857.34
UMass Memorial Health-Harrington Hospital	—	—	$2,857.34
Webster County Memorial Hospital	Webster Springs	WV	$2,857.34
UMass Memorial Medical Center University Campus	—	—	$3,777
Marlborough Hospital	Marlborough	MA	$3,777
Umass Memorial Medical Center	Worcester	MA	$3,777
UMass Memorial Medical Center-Marlborough Campus	—	—	$3,777

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States with hospitals publishing rates for wellpoint [11112].

State	Hospitals	Avg rate
MA	4	$3,311.91
WV	1	$2,857.34

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