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PRIME HEALTHCARE SERVICES - ST MICHAELS LLC

General Acute Care Hospital·NEWARK, NJ·NPI: 1568825545Share

Compared to General Acute Care Hospital Peers

Total spending distribution among 156 providers in this specialty

P25MedianP75P90

This provider's total spending of $67.7M is at the below 25th percentile among 156 General Acute Care Hospital providers.

Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$67.7M

$67,668,437

Total Claims

1.5M

Beneficiaries

1.1M

1.3 claims/patient

Avg Cost/Claim

$46

Monthly Spending Trend

Yearly Spending

2018
$13.6M
-9%
2019
$12.4M
-48%
2020
$6.4M
+66%
2021
$10.7M
-16%
2022
$9.0M
-8%
2023
$8.3M
-13%
2024
$7.2M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 50 distinct procedure codes. The top code (99283 (Emergency dept visit, moderate complexity)) accounts for 15% of total spending.

99283Top 5%

Emergency dept visit, moderate complexity

$10.2M

51K claims · 15.1%

Your Cost: $201.00/claim|Median: $42.48
4.7× median
99284Top 5%

Emergency dept visit, high complexity

$9.4M

38K claims · 13.9%

Your Cost: $245.66/claim|Median: $69.51
3.5× median
99285Top 10%

Emergency dept visit, high/urgent complexity

$9.3M

32K claims · 13.7%

Your Cost: $286.18/claim|Median: $85.65
3.3× median
74177Top 10%

CT abdomen and pelvis with contrast

$2.7M

5,961 claims · 4.0%

Your Cost: $448.51/claim|Median: $65.76
6.8× median
OP370Top 10%

$2.4M

12K claims · 3.5%

Your Cost: $203.00/claim|Median: $82.47
2.5× median
OP272Normal range

$2.0M

61K claims · 3.0%

Your Cost: $33.27/claim|Median: $28.37
1.2× median
70450Top 25%

CT head/brain without contrast

$1.7M

9,884 claims · 2.4%

Your Cost: $167.05/claim|Median: $45.53
3.7× median
74176Top 5%

CT abdomen and pelvis without contrast

$1.4M

3,540 claims · 2.0%

Your Cost: $381.93/claim|Median: $60.19
6.3× median
93005Top 25%

Electrocardiogram, tracing only, without interpretation

$1.3M

30K claims · 2.0%

Your Cost: $44.96/claim|Median: $7.50
6.0× median
43239Top 10%

Upper GI endoscopy with biopsy

$1.3M

2,795 claims · 1.9%

Your Cost: $449.33/claim|Median: $151.68
3.0× median
96361Normal range

IV infusion, hydration, each additional hour

$946K

13K claims · 1.4%

Your Cost: $71.24/claim|Median: $38.92
1.8× median
96374Normal range

Therapeutic/prophylactic/diagnostic IV push, single substance

$872K

23K claims · 1.3%

Your Cost: $38.67/claim|Median: $21.76
1.8× median
OP271Top 25%

$811K

68K claims · 1.2%

Your Cost: $11.97/claim|Median: $6.79
1.8× median
45378Top 25%

Colonoscopy, diagnostic

$774K

1,502 claims · 1.1%

Your Cost: $515.58/claim|Median: $225.49
2.3× median
G0378Normal range

Hospital observation service, per hour

$704K

2,981 claims · 1.0%

Your Cost: $236.07/claim|Median: $99.39
2.4× median
G0463Normal range

Hospital outpatient clinic visit

$654K

33K claims · 1.0%

Your Cost: $19.73/claim|Median: $26.41
0.7× median
96413Top 25%

Chemotherapy administration, IV infusion, up to 1 hour

$631K

3,780 claims · 0.9%

Your Cost: $166.97/claim|Median: $75.28
2.2× median
71045Top 10%

Chest X-ray, single view

$618K

20K claims · 0.9%

Your Cost: $30.58/claim|Median: $4.93
6.2× median
Q9967Top 10%

Low osmolar contrast material, 300-399 mg iodine/ml, per ml

$616K

11K claims · 0.9%

Your Cost: $57.87/claim|Median: $3.42
16.9× median
45380Normal range

Colonoscopy with biopsy

$603K

1,864 claims · 0.9%

Your Cost: $323.65/claim|Median: $200.68
1.6× median
93458Normal range

Left heart catheterization with imaging

$587K

670 claims · 0.9%

Your Cost: $876.49/claim|Median: $183.33
4.8× median
94640Top 10%

Pressurized or nonpressurized inhalation treatment

$579K

8,748 claims · 0.9%

Your Cost: $66.14/claim|Median: $10.88
6.1× median
71275Top 10%

CT angiography, chest, with contrast

$557K

1,903 claims · 0.8%

Your Cost: $292.76/claim|Median: $92.96
3.1× median
77067Normal range

Screening mammography, bilateral, including CAD

$515K

7,994 claims · 0.8%

Your Cost: $64.41/claim|Median: $39.33
1.6× median
96375Top 25%

Therapeutic/prophylactic/diagnostic IV push, each additional substance

$503K

13K claims · 0.7%

Your Cost: $37.57/claim|Median: $14.92
2.5× median
80053Normal range

Comprehensive metabolic panel

$474K

55K claims · 0.7%

Your Cost: $8.70/claim|Median: $7.24
1.2× median
96372Top 10%

Therapeutic injection, subcutaneous/intramuscular

$462K

20K claims · 0.7%

Your Cost: $23.06/claim|Median: $9.56
2.4× median
72125Top 10%

CT cervical spine without contrast

$451K

2,025 claims · 0.7%

Your Cost: $222.51/claim|Median: $32.30
6.9× median
93306Top 5%

Echocardiography, transthoracic, complete, with Doppler

$435K

1,428 claims · 0.6%

Your Cost: $304.92/claim|Median: $54.68
5.6× median
71046Top 10%

Chest X-ray, 2 views

$422K

11K claims · 0.6%

Your Cost: $38.81/claim|Median: $8.92
4.4× median
OP250Normal range

Orthotic or prosthetic procedure, not otherwise classified

$421K

129K claims · 0.6%

Your Cost: $3.27/claim|Median: $1.68
1.9× median
87426Normal range

SARS-CoV-2 COVID-19 antigen detection, immunoassay

$417K

16K claims · 0.6%

Your Cost: $26.34/claim|Median: $30.04
0.9× median
45385Normal range

Colonoscopy with polyp removal, snare technique

$412K

972 claims · 0.6%

Your Cost: $423.87/claim|Median: $255.17
1.7× median
88305Normal range

Surgical pathology, gross and microscopic examination

$408K

7,572 claims · 0.6%

Your Cost: $53.89/claim|Median: $35.80
1.5× median
66984Top 25%

Extracapsular cataract removal with IOL insertion

$398K

715 claims · 0.6%

Your Cost: $556.56/claim|Median: $268.70
2.1× median
99281Normal range

Emergency dept visit, minimal complexity

$387K

3,977 claims · 0.6%

Your Cost: $97.36/claim|Median: $52.03
1.9× median
96365Normal range

IV infusion, therapeutic/prophylactic/diagnostic, initial, up to 1 hour

$384K

4,780 claims · 0.6%

Your Cost: $80.31/claim|Median: $54.77
1.5× median
85025Normal range

Complete blood count (CBC) with differential, automated

$360K

64K claims · 0.5%

Your Cost: $5.66/claim|Median: $4.71
1.2× median
J1756Top 10%

Injection, iron sucrose, 1 mg

$328K

3,364 claims · 0.5%

Your Cost: $97.60/claim|Median: $4.58
21.3× median
U0003Normal range

Infectious disease detection (COVID-19)

$325K

6,261 claims · 0.5%

Your Cost: $51.93/claim|Median: $63.08
0.8× median
77063Top 10%

Screening digital breast tomosynthesis, bilateral

$323K

6,594 claims · 0.5%

Your Cost: $49.01/claim|Median: $21.41
2.3× median
73630Top 5%

X-ray, foot, complete, minimum 3 views

$289K

4,209 claims · 0.4%

Your Cost: $68.73/claim|Median: $12.06
5.7× median
84484Top 25%

Troponin, quantitative

$271K

24K claims · 0.4%

Your Cost: $11.17/claim|Median: $4.84
2.3× median
80307Normal range

Drug test, presumptive, by chemistry analyzers

$256K

6,911 claims · 0.4%

Your Cost: $36.99/claim|Median: $35.43
1.0× median
76830Top 10%

Ultrasound, transvaginal

$242K

2,076 claims · 0.4%

Your Cost: $116.79/claim|Median: $57.47
2.0× median
96360Normal range

IV infusion, hydration, initial, 31 minutes to 1 hour

$226K

4,630 claims · 0.3%

Your Cost: $48.83/claim|Median: $61.57
0.8× median
87804Top 25%

Influenza virus detection, rapid test

$226K

13K claims · 0.3%

Your Cost: $17.32/claim|Median: $12.59
1.4× median
73130Top 5%

$210K

2,751 claims · 0.3%

Your Cost: $76.51/claim|Median: $10.69
7.2× median
70486Top 10%

$210K

1,147 claims · 0.3%

Your Cost: $182.99/claim|Median: $44.28
4.1× median
73030Top 5%

$209K

3,054 claims · 0.3%

Your Cost: $68.39/claim|Median: $10.94
6.3× median

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