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Short Term Acute Care HospitalVoluntary Non-Profit - Private

Peninsula Regional Medical Center

Peninsula Regional Health System ยท Salisbury, MD

100 East Carroll Street, Salisbury, MD 21801(410) 543-7111

40

In-network payers

228

Disclosed rate categories

266

Beds

4

Care quality

About this hospital

Peninsula Regional Medical Center is a 266-bed voluntary non-profit - private hospital in Salisbury, MD, affiliated with Peninsula Regional Health System. Below you'll find publicly disclosed negotiated rates and facility details, including 40 in-network payers and 228 disclosed rate categories.

CCN (Medicare provider number)

210019

NPI

1780689463

Type

Short Term Acute Care Hospital

Ownership

Voluntary Non-Profit - Private

Beds

266

Care Quality

4

Insurance Accepted

Insurance acceptance may vary by specific plan, network status, and services required. Contact your insurance provider or the hospital's billing department to confirm coverage details.

Medicare
Aetna
BCBS
Cigna
United Healthcare (incl Optum, Rocky Mountain, Health Plan of Nevada, Sierra Health)
Ameri HealthAspirus Health PlanAvera Health PlansBanner HealthCenteneDean Health Plan

Negotiated Rates

The data below comes from CMS-mandated price transparency data. Learn more.

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PayerCategoryCode Type & GroupContract Typevs. State Average

Aetna

Outpatient

CPT Evaluation and Management

Range: 99091 - 99499

Percentage of Bill Charged

-

Aetna

Outpatient

CPT Medicine Services and Procedures

Range: 90281 - 99607

Percentage of Bill Charged

-

Aetna

Outpatient

CPT Pathology and Laboratory Procedures

Range: 80047 - 89398

Percentage of Bill Charged

-

Aetna

Outpatient

CPT Proprietary Laboratory Analyses

Range: 0001U - 0401U

Percentage of Bill Charged

-

Aetna

Outpatient

CPT Radiology Procedures

Range: 70010 - 79999

Percentage of Bill Charged

-

Aetna

Outpatient

CPT Surgery

Range: 10004 - 69990

Percentage of Bill Charged

-

Aetna

Outpatient

HCPCS Administrative, Miscellaneous and Investigational

Range: A9150 - A9999

Percentage of Bill Charged

-

Aetna

Outpatient

HCPCS Alcohol and Drug Abuse Treatment

Range: H0001 - H2037

Percentage of Bill Charged

-

Aetna

Outpatient

HCPCS Chemotherapy Drugs

Range: J9000 - J9999

Percentage of Bill Charged

-

Aetna

Outpatient

HCPCS Coronavirus Diagnostic Panel

Range: U0001 - U0005

Percentage of Bill Charged

-

Rates shown are negotiated amounts between this hospital and insurance providers. Actual patient costs depend on your insurance plan and coverage details.

Showing 1 - 10 of 228

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Location

100 East Carroll Street, Salisbury, MD 21801

(410) 543-7111

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Frequently asked questions

About Peninsula Regional Medical Center's rates and hospital price transparency.

How many beds does Peninsula Regional Medical Center have?

Peninsula Regional Medical Center has 266 beds. Facility type: Short Term Acute Care Hospital.

Where is Peninsula Regional Medical Center and what is its phone number?

Peninsula Regional Medical Center is located at 100 East Carroll Street, Salisbury, MD 21801. Its main phone number is (410) 543-7111.

What is Peninsula Regional Medical Center's CCN (Medicare provider number)?

Peninsula Regional Medical Center's CMS Certification Number (CCN), also called its Medicare provider number, is 210019.

What is Peninsula Regional Medical Center's NPI number?

The National Provider Identifier (NPI) on file for Peninsula Regional Medical Center is 1780689463.

What health system is Peninsula Regional Medical Center part of?

Peninsula Regional Medical Center is affiliated with Peninsula Regional Health System.

Which insurance plans are in network at Peninsula Regional Medical Center?

Peninsula Regional Medical Center lists 40 in-network payers, including Aetna, Ameri Health, Aspirus Health Plan, Avera Health Plans, and is Medicare-certified. Insurance acceptance may vary by plan, so confirm coverage with your insurer or the hospital's billing department.

What price transparency data is available for Peninsula Regional Medical Center?

228 disclosed rate categories. Each shows the payer, category, code type and group with its code range, and contract type, along with how the rate compares with the state average.

What is a hospital price transparency MRF?

Under 45 CFR Part 180, every US hospital must publish a machine-readable file of its standard charges, including gross charges, discounted cash prices and payer-specific negotiated rates, in the CMS template format. PayerPrice can help hospitals publish and maintain these files.

What is a chargemaster review?

A chargemaster (charge description master, or CDM) is a hospital's master list of billable items, with codes, descriptions and gross charges. A chargemaster review looks at those lines for accuracy and pricing. PayerPrice can help hospitals review their chargemaster; contact us to discuss your needs.

For hospital finance and compliance teams

Running price transparency at a hospital like this one?

The data on this page comes from the files hospitals and payers publish. We help hospitals publish theirs correctly, and take a fresh look at their chargemaster.

Compliance MRF

Publish a CMS-compliant machine-readable file

We turn your chargemaster and payer contracts into the CMS template file, then keep it current as rates change.

CMS v3 example: standard_charge_information[0]
{
  "description": "MRI of brain (no contrast)",
  "code_information": [
    { "code": "611", "type": "RC" },
    { "code": "70551", "type": "CPT" }
  ],
  "standard_charges": [{
    "setting": "outpatient",
    "minimum": 250,
    "maximum": 400,
    "gross_charge": 1200,
    "discounted_cash": 1080,
    "payers_information": [
      {
        "payer_name": "Platform Health Insurance",
        "plan_name": "PPO",
        "methodology": "fee schedule",
        "standard_charge_dollar": 400
      },
      {
        "payer_name": "Region Health Insurance",
        "plan_name": "HMO",
        "methodology": "fee schedule",
        "standard_charge_dollar": 250
      }
    ]
  }]
}
  • CMS template layout, in JSON or CSV
  • Gross, discounted cash, payer-specific and de-identified min / max charges
  • cms-hpt.txt file and homepage footer link
  • Refreshed when your contracts change
Talk to us about your MRF
Chargemaster analysis

Get your chargemaster right for billing and payer contracts

Your chargemaster sets the gross charge on every claim, and many payer contracts base payment on it through percent-of-charge, lesser-of and stop-loss terms. We audit it line by line and show how your charges and negotiated rates compare with peer hospitals before your next negotiation.

What a review covers

CodingPricingPayer contractsCompliance
  • CPT, HCPCS, revenue code and modifier errors flagged line by line
  • Missing, duplicate and outdated charge lines identified
  • Charges set below payer allowables caught before lesser-of clauses cut payment
  • Revenue impact of charge changes modeled across percent-of-charge and stop-loss terms
  • Your negotiated rates benchmarked against peer hospitals for the same payers
Talk to us about your chargemaster