For employer-benefits brokers and self-funded groups
The same procedure. Three places. Three prices.
A self-funded employer pays the claim itself, so where the procedure happens is the invoice. Show a client this spread at renewal and you are the broker who found it.
Moving this one procedure out of the hospital outpatient department and into a surgery centre is $439.61 on a single claim. The hospital is 168% above the office.
Federal allowed amounts, not a commercial contract and not a quote. Office is the non-facility physician fee. Surgery centre and hospital are the physician fee plus that setting's facility payment, which is why they are higher and why a facility column without the physician fee understates both.
- Federal fee schedules, physician and facility, joined per locality.
- Out-of-network and IDR outcomes against the qualifying payment amount.
- Network structure by named system, with the denominator printed.
The full console on real federal data. Sacramento already loaded. No card, no PIN, no call, nothing to type.
No PHI, ever. We never ask for a member, a claim or a census file to show you this.