Allied Benefit: disclosed hospital rates

iDirect answer

Based on the published hospital price files, Allied Benefit appears in disclosed negotiated rates across 1 hospital and 373 services. This is public hospital price transparency data, not a guaranteed estimate of your bill.

Actual patient responsibility may vary based on your insurance plan, deductible, coinsurance, network status, diagnosis, setting, bundled services, clinical circumstances, and hospital billing practices.

373 prices shown.

Service	Hospital	Code	List price	Cash price	Negotiated range	Allowed (median)
85385 FIBRINOGEN ANTIGEN Inpatient	Community Hospital of Bremen	85385 CPT	$62.00	$40.30	$31.00 – $80.60	—
ADDL HR-Cumulative > 30 MIN Inpatient	Community Hospital of Bremen	96361 CPT	$194	$126	$97.00 – $252	—
Alcohol (Ethanol) Breath Inpatient	Community Hospital of Bremen	82075 CPT	$62.00	$40.30	$31.00 – $80.60	—
ANCHOR D 5.5MM HEALIX TI 3 W/ORTHOCORD Inpatient	Community Hospital of Bremen	C1713 CPT	$2,096	$1,362	$1,048 – $2,725	—
ANCHOR D 6.5MM HEALIX TI 3 W / ORTHOCORD Inpatient	Community Hospital of Bremen	C1713 CPT	$2,096	$1,362	$1,048 – $2,725	—
ANCHOR MITEK G2 PLUS W/ORTHOCORD Inpatient	Community Hospital of Bremen	C1713 CPT	$2,457	$1,597	$1,229 – $3,194	—
ANCHOR ORTHO HEALIX TI 6.5 W/NDL Inpatient	Community Hospital of Bremen	C1713 CPT	$2,096	$1,362	$1,048 – $2,725	—
Ankle Trimalleolar Fracture With Manipulation - Both Inpatient	Community Hospital of Bremen	27818 CPT	$3,102	$2,016	$1,551 – $4,033	—
APPLICATION RIGID CAST LEG Inpatient	Community Hospital of Bremen	29445 CPT	$1,151	$748	$576 – $1,496	—
BEARING HUMERAL STANDARD 36MM Inpatient	Community Hospital of Bremen	C1776 CPT	$4,830	$3,140	$2,415 – $6,279	—
BIOLOX Z DELTA FEM HEAD 32MM +0MM Inpatient	Community Hospital of Bremen	C1776 CPT	$3,667	$2,384	$1,834 – $4,767	—
BIOLOX Z DELTA FEM HEAD 36MM -3.5MM Inpatient	Community Hospital of Bremen	C1713 CPT	$3,667	$2,384	$1,834 – $4,767	—
Blood Transfusion-FFP Inpatient	Community Hospital of Bremen	36430 CPT	$812	$528	$406 – $1,056	—
Blood Transfusion-Packed RBC Inpatient	Community Hospital of Bremen	36430 CPT	$812	$528	$406 – $1,056	—
Blood Transfusion-Platelets Inpatient	Community Hospital of Bremen	36430 CPT	$812	$528	$406 – $1,056	—
Carbamazepine Level, Unbound (Free), Serum or Plasma Inpatient	Community Hospital of Bremen	80157 CPT	$29.00	$18.85	$14.50 – $37.70	—
Cardioversion Elective Arrhythmia External Inpatient	Community Hospital of Bremen	92960 CPT	$1,655	$1,076	$828 – $2,152	—
CEMENT BONE R REFOBACIN Inpatient	Community Hospital of Bremen	C1713 CPT	$591	$384	$296 – $768	—
CIRCUIT KIT INFANT 10MM DISP Inpatient	Community Hospital of Bremen	256427232 CDM	$187	$122	$93.50 – $243	—
COLLAGEN CELLERATE RX SURGICAL ACTIVATED 1GM Inpatient	Community Hospital of Bremen	A6011 CPT	$1,596	$1,037	$798 – $2,075	—
COLLAGEN CELLERATE RX SURGICAL ACTIVATED 5GM Inpatient	Community Hospital of Bremen	A6011 CPT	$5,859	$3,808	$2,930 – $7,617	—
COLOR MAPPING CHG ONLY Inpatient	Community Hospital of Bremen	93325 CPT	$226	$147	$113 – $294	—
COMPLETE ECHO W/COLOR FLOW DOPPLR CHG ONLY Inpatient	Community Hospital of Bremen	93306 CPT	$2,328	$1,513	$1,164 – $3,026	—
CONTRAST MEDIA-DEFINITY CHG ONLY Inpatient	Community Hospital of Bremen	Q9957 CPT	$1,478	$961	$739 – $1,921	—
Cortisol Free, Equilibrium Dialysis and LC/MS-MS Inpatient	Community Hospital of Bremen	82530 CPT	$51.00	$33.15	$25.50 – $66.30	—