BLUE CROSS - AK (PREMERA): disclosed hospital rates

iDirect answer

Based on the published hospital price files, BLUE CROSS - AK (PREMERA) appears in disclosed negotiated rates across 1 hospital and 14 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.

14 prices shown.

Service	Hospital	Code	List price	Cash price	Negotiated range	Allowed (median)
HC Blood Typing Ag Donor Ea Ag Inpatient & outpatient	MercyOne Dubuque Medical Center	PX-30086902001 CDM	$93.00	$60.45	$6.35 – $716	—
HC Blood Typing RBC Ag Non Abo/Rh Ea Inpatient & outpatient	MercyOne Dubuque Medical Center	PX-30086905001 CDM	$139	$90.35	$3.83 – $716	—
HC Blood Typing Rh Phenotype Complete Reference Inpatient & outpatient	MercyOne Dubuque Medical Center	PX-30086906002 CDM	$211	$137	$7.75 – $211	—
HC Compatibility Test Incubate Inpatient & outpatient	MercyOne Dubuque Medical Center	PX-30086921001 CDM	$39.00	$25.35	$14.27 – $340	—
HC Coombs Direct Inpatient & outpatient	MercyOne Dubuque Medical Center	PX-30086880001 CDM	$110	$71.50	$5.39 – $118	—
HC Coombs Direct C3dc3b Inpatient & outpatient	MercyOne Dubuque Medical Center	PX-30086880002 CDM	$110	$71.50	$5.39 – $118	—
HC Coombs Direct Igg Inpatient & outpatient	MercyOne Dubuque Medical Center	PX-30086880003 CDM	$110	$71.50	$5.39 – $118	—
HC Coombs Direct Reference Inpatient & outpatient	MercyOne Dubuque Medical Center	PX-30086880004 CDM	$110	$71.50	$5.39 – $118	—
HC Coombs Indirect Titer Reference Inpatient & outpatient	MercyOne Dubuque Medical Center	PX-30086886008 CDM	$151	$98.15	$5.18 – $340	—
HC External Pretreatment of Serum for Use in Antibody Identification by Dilution Inpatient & outpatient	MercyOne Dubuque Medical Center	PX-30086976002 CDM	$78.00	$50.70	$24.96 – $78.00	—
HC Pretreat RBC Absorption Reference Inpatient & outpatient	MercyOne Dubuque Medical Center	PX-30086978002 CDM	$267	$174	$33.96 – $267	—
HC Pretreat RBC Density Gradient Separation Reference Inpatient & outpatient	MercyOne Dubuque Medical Center	PX-30086972002 CDM	$348	$226	$127 – $348	—
HC Pretreat RBC W Enzyme Reference Inpatient & outpatient	MercyOne Dubuque Medical Center	PX-30086971002 CDM	$228	$148	$83.45 – $340	—
HC Pretreatment Serum by Diff Red Cell Adsorption Patient RBC/Known Phenotype Each Adsorption Ref Inpatient & outpatient	MercyOne Dubuque Medical Center	PX-30086977001 CDM	$919	$597	$153 – $919	—