00006307604 — Prevymis Tab 480mg
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). PREVYMIS TAB 480MG (NDC 00006307604) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/00006307604?code_type=NDC
MLA (9th ed.)
“PREVYMIS TAB 480MG (NDC 00006307604) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/00006307604?code_type=NDC. Accessed .
Chicago (notes-bibliography)
“PREVYMIS TAB 480MG (NDC 00006307604) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/00006307604?code_type=NDC.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $533–$931 (25th–75th percentile) across 18 hospitals · 189 payers.
“Negotiated” is the hospital’s negotiated facility rate for this NDC 00006307604 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.
Per-month price trends are temporarily unavailable while we rebuild them on quality-filtered rates. The medians, percentiles, and per-hospital rates on this page are the quality-filtered figures.
Hospital rates (per row)
Showing consumer-grade rates only. Flagged / outlier filings (excluded from the medians above) are hidden — tick “Show flagged / outlier rates” to include them.
| Hospital | Payer | Plan | Negotiated rate | Gross | Cash | Observed | Source |
|---|---|---|---|---|---|---|---|
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | HAP | Self Insured | $2.10 | $785.46 | — | 2025-06-28 | MRF ↗ |
| NORTHSIDE HOSPITAL CHEROKEE Outpatient | Institutional GA Medicaid | Institutional GA Medicaid | $160.11 | $1,432.50 | $1,074.38 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL CHEROKEE Outpatient | Amerigroup | Amerigroup Medicaid | $160.11 | $1,432.50 | $1,074.38 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL CHEROKEE Outpatient | Centene | Peach State Medicaid | $160.11 | $1,432.50 | $1,074.38 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL CHEROKEE Outpatient | CareSource | CareSource | $164.91 | $1,432.50 | $1,074.38 | 2026-02-14 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | BCBS | Medicare Advantage-PPO | $168.17 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | BCBS | Medicare Advantage-PPO | $168.17 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| NORTHSIDE HOSPITAL FORSYTH Outpatient | Centene | Peach State Medicaid | $172.61 | $1,432.50 | $1,074.38 | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL FORSYTH Outpatient | Amerigroup | Amerigroup Medicaid | $172.61 | $1,432.50 | $1,074.38 | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL FORSYTH Outpatient | Institutional GA Medicaid | Institutional GA Medicaid | $172.61 | $1,432.50 | $1,074.38 | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL FORSYTH Outpatient | CareSource | CareSource | $177.79 | $1,432.50 | $1,074.38 | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL DULUTH Outpatient | Amerigroup | Amerigroup Medicaid | $180.94 | $1,432.50 | $1,074.38 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL DULUTH Outpatient | Institutional Gwinnett County Govt | Institutional Gwinnett County Govt | $180.94 | $1,432.50 | $1,074.38 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL DULUTH Outpatient | Institutional GA Medicaid | Institutional GA Medicaid | $180.94 | $1,432.50 | $1,074.38 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL DULUTH Outpatient | Centene | Peach State Medicaid | $180.94 | $1,432.50 | $1,074.38 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL CHEROKEE Outpatient | Institutional 115 Percent_Georgia Medicaid | Institutional 115 Percent_Georgia Medicaid | $184.12 | $1,432.50 | $1,074.38 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL DULUTH Outpatient | CareSource | CareSource | $186.37 | $1,432.50 | $1,074.38 | 2026-02-14 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | BCBS | Medicare Advantage-HMO | $195.30 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | BCBS | Medicare Advantage-HMO | $195.30 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| FLAGLER HOSPITAL OutpatientFacility | Aetna | Medicare Advantage | $195.30 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| NORTHSIDE HOSPITAL FORSYTH Outpatient | Institutional 115 Percent_Georgia Medicaid | Institutional 115 Percent_Georgia Medicaid | $198.50 | $1,432.50 | $1,074.38 | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL FORSYTH Outpatient | Amerigroup | Amerigroup Medicare Advantage | $203.77 | $1,432.50 | $1,074.38 | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL FORSYTH Outpatient | Cigna | CIGNA HealthSprings Medicare Advantage | $205.73 | $1,432.50 | $1,074.38 | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL DULUTH Outpatient | Institutional 115 Percent_Georgia Medicaid | Institutional 115 Percent_Georgia Medicaid | $208.08 | $1,432.50 | $1,074.38 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL CHEROKEE Outpatient | Amerigroup | Amerigroup Medicare Advantage | $212.56 | $1,432.50 | $1,074.38 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL CHEROKEE Outpatient | Cigna | CIGNA HealthSprings Medicare Advantage | $214.61 | $1,432.50 | $1,074.38 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL GWINNETT Outpatient | Amerigroup | Amerigroup Medicare Advantage | $215.50 | $1,432.50 | $1,074.38 | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL GWINNETT Outpatient | Cigna | CIGNA HealthSprings Medicare Advantage | $217.57 | $1,432.50 | $1,074.38 | 2026-02-15 | MRF ↗ |
| UF HEALTH SHANDS HOSPITAL OutpatientFacility | BCBS | Medicare Advantage-HMO | $222.42 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| UF HEALTH SHANDS HOSPITAL OutpatientFacility | BCBS | Medicare Advantage-PPO | $222.42 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| NORTHSIDE HOSPITAL Outpatient | Amerigroup | Amerigroup Medicare Advantage | $231.62 | $1,432.50 | $1,074.38 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL Outpatient | Cigna | CIGNA HealthSprings Medicare Advantage | $233.85 | $1,432.50 | $1,074.38 | 2026-02-14 | MRF ↗ |
| FLAGLER HOSPITAL OutpatientFacility | Aetna | All Products | $234.36 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | MOLINA | MARKETPLACE | $235.64 | $785.46 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | Molina MI Health Link | MEDICARE ADVANTAGE | $235.64 | $785.46 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | MOLINA | MARKETPLACE | $235.64 | $785.46 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | Molina MI Health Link | MEDICARE ADVANTAGE | $235.64 | $785.46 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | WellCare | Medicare Advantage | $237.21 | $785.46 | — | 2025-06-28 | MRF ↗ |
| NORTHSIDE HOSPITAL DULUTH Outpatient | Amerigroup | Amerigroup Medicare Advantage | $246.28 | $1,432.50 | $1,074.38 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL DULUTH Outpatient | Cigna | CIGNA HealthSprings Medicare Advantage | $248.65 | $1,432.50 | $1,074.38 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL GWINNETT Outpatient | Institutional GA Medicaid | Institutional GA Medicaid | $257.23 | $1,432.50 | $1,074.38 | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL GWINNETT Outpatient | Institutional Gwinnett County Govt | Institutional Gwinnett County Govt | $257.23 | $1,432.50 | $1,074.38 | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL GWINNETT Outpatient | Amerigroup | Amerigroup Medicaid | $257.23 | $1,432.50 | $1,074.38 | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL GWINNETT Outpatient | Centene | Peach State Medicaid | $257.23 | $1,432.50 | $1,074.38 | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL Outpatient | Amerigroup | Amerigroup Medicaid | $260.28 | $1,432.50 | $1,074.38 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL Outpatient | Institutional GA Medicaid | Institutional GA Medicaid | $260.28 | $1,432.50 | $1,074.38 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL Outpatient | Centene | Peach State Medicaid | $260.28 | $1,432.50 | $1,074.38 | 2026-02-14 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | Aetna Health | Medicare Advantage | $260.40 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | Aetna Health | Medicare Advantage | $260.40 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Health Plan of Nevada Medicare | Medicare | — | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | TriWest Healthcare Alliance | Other Government | — | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | UCLA Health Medicare Advantage Plan | Medicare Advantage | $261.32 | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Redlands Community Medicare | Medicare | — | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | TriWest Healthcare Alliance | Other Government | — | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Anthem Medicare | Medicare | — | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Torrance Memorial Medicare | HMO-Medicare | — | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Aetna Medicare | Medicare | $261.32 | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | UCLA Health Medicare Advantage Plan | Medicare Advantage | $261.32 | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Prime Health - Medicare | Medicare | — | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | St. Jude | Medicare HMO | — | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Redlands Community Medicare | Medicare | — | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Aetna Medicare | Medicare | $261.32 | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | TriWest Healthcare Alliance | Other Government | — | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | CenCal Transplant Medi-Cal HMO | Medi-Cal HMO | — | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | UCLA Health Medicare Advantage Plan | Medicare Advantage | $261.32 | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Health Plan of Nevada Medicare | Medicare | — | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Torrance Memorial Medicare | HMO-Medicare | — | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Central Health Plan | Medicare HMO | — | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Prime Health - Medicare | Medicare | — | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | UHC Mediare Advantage | Medicare Advantage | — | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Centivo | PPO | — | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Centivo | PPO | — | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| NORTHSIDE HOSPITAL GWINNETT Outpatient | CareSource | CareSource | $264.95 | $1,432.50 | $1,074.38 | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL FORSYTH Outpatient | Centene | Peach State Medicare | $266.41 | $1,432.50 | $1,074.38 | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL Outpatient | CareSource | CareSource | $268.08 | $1,432.50 | $1,074.38 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL CHEROKEE Outpatient | Centene | Peach State Medicare | $274.87 | $1,432.50 | $1,074.38 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL GWINNETT Outpatient | Centene | Peach State Medicare | $277.69 | $1,432.50 | $1,074.38 | 2026-02-15 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | WellCare | Medicare Advantage | $281.67 | $785.46 | — | 2025-06-28 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Gold Coast Health Plan | HMO | $292.68 | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Gold Coast Health Plan | HMO | $292.68 | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| NORTHSIDE HOSPITAL Outpatient | Centene | Peach State Medicare | $293.19 | $1,432.50 | $1,074.38 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL GWINNETT Outpatient | Institutional 115 Percent_Georgia Medicaid | Institutional 115 Percent_Georgia Medicaid | $295.81 | $1,432.50 | $1,074.38 | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL Outpatient | Institutional 115 Percent_Georgia Medicaid | Institutional 115 Percent_Georgia Medicaid | $299.32 | $1,432.50 | $1,074.38 | 2026-02-14 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Anthem Workers Comp | Workers Comp | $299.89 | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | Anthem Vivity, Anthem HMO | HMO-City of LA | $306.37 | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Anthem Vivity-Anthem HMO | All Products-HMO | $306.37 | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| NORTHSIDE HOSPITAL DULUTH Outpatient | Centene | Peach State Medicare | $307.29 | $1,432.50 | $1,074.38 | 2026-02-14 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | BCBS | Gatorcare | $320.07 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | BCBS | Gatorcare | $320.07 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE BothFacility | WellCare of Florida | Medicare Advantage/HMO/POS/SNP | $325.49 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE BothFacility | WellCare of Florida | Medicare Advantage/HMO/POS/SNP | $325.49 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | BCBS | Blue Select PPO | $332.44 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | BCBS | Blue Select PPO | $332.44 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Anthem Vivity, Anthem HMO | HMO-City of LA | $339.93 | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | UC Care - PPO | PPO | $342.85 | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | BCBS | SimplyBlue Commercial | $343.29 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | BCBS | SimplyBlue Commercial | $343.29 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | BCBS | MyBlue HMO | $343.29 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | BCBS | MyBlue HMO | $343.29 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Anthem Vivity, Anthem HMO | HMO-NonCity of LA | $344.84 | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | UC Ship | PPO | $351.21 | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | UC Ship | PPO | $351.21 | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Providence Healthcare | Medicare | $365.85 | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Health Care LA - RMG | All Products | $365.85 | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Health Care LA MediCal - RMG | Medicaid Advantage | $365.85 | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | CenCal Medi-Cal HMO | Medi-Cal HMO | $365.85 | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Providence Healthcare | Medicare | $365.85 | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Health Care LA MediCal - RMG | Medicaid Advantage | $365.85 | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | CenCal Transplant Medi-Cal HMO | Medi-Cal HMO | $365.85 | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Health Care LA - RMG | All Products | $365.85 | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Blue Shield | Medicare Advantage | $365.85 | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Blue Shield | Medicare Advantage | $365.85 | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Anthem Vivity, Anthem HMO | HMO-NonCity of LA | $382.99 | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | Anthem Vivity, Anthem HMO | HMO-NonCity of LA | $382.99 | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | VitalCore Physicians Group of MI | All Products | $392.73 | $785.46 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | VitalCore Physicians Group of MI | All Products | $392.73 | $785.46 | — | 2025-06-28 | MRF ↗ |
| FLAGLER HOSPITAL OutpatientFacility | BCBS | My Blue | $393.85 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| NORTHSIDE HOSPITAL DULUTH Outpatient | BCBS | BCBS_PATHWAY-L | $400.24 | $1,432.50 | $1,074.38 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL Outpatient | BCBS | BCBS_PATHWAY | $400.24 | $1,432.50 | $1,074.38 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL Outpatient | BCBS | BCBS_PATHWAY-L | $400.24 | $1,432.50 | $1,074.38 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL FORSYTH Outpatient | BCBS | BCBS_PATHWAY-L | $400.24 | $1,432.50 | $1,074.38 | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL DULUTH Outpatient | BCBS | BCBS_PATHWAY | $400.24 | $1,432.50 | $1,074.38 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL CHEROKEE Outpatient | BCBS | BCBS_PATHWAY-L | $400.24 | $1,432.50 | $1,074.38 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL CHEROKEE Outpatient | BCBS | BCBS_PATHWAY | $400.24 | $1,432.50 | $1,074.38 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL FORSYTH Outpatient | BCBS | BCBS_PATHWAY | $400.24 | $1,432.50 | $1,074.38 | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL GWINNETT Outpatient | BCBS | BCBS_PATHWAY | $400.24 | $1,432.50 | $1,074.38 | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL GWINNETT Outpatient | BCBS | BCBS_PATHWAY-L | $400.24 | $1,432.50 | $1,074.38 | 2026-02-15 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | HAP | Fully Insured | $407.10 | $785.46 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | NFL Health Services - Cigna | ALL PRODUCTS | $408.44 | $785.46 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | NFL Health Services - Cigna | ALL PRODUCTS | $408.44 | $785.46 | — | 2025-06-28 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | UC Care - PPO | PPO | $408.70 | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | Florida Health Care Plan | MEDICARE HMO | $412.29 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | Florida Health Care Plan | MEDICARE HMO | $412.29 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| UF HEALTH SHANDS HOSPITAL BothFacility | UAA | Student Athletes | $413.38 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | BCBS | Commercial-HMO | $414.46 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | BCBS | Commercial-HMO | $414.46 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | LA care Medi-Cal HMO | Medi-Cal HMO | $418.11 | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | UCI University - RMG | All Products | $418.11 | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Molina Healthcare HMO | MediCal HMO | $418.11 | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Children Hospital of Orange County | Medicaid HMO | $418.11 | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | UCI University - RMG | All Products | $418.11 | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Children Hospital of Orange County | Medicaid HMO | $418.11 | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | LA care Medi-Cal HMO | Medi-Cal HMO | $418.11 | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Molina Healthcare HMO | MediCal HMO | $418.11 | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| Henry Ford Hospital BothFacility | Priority Health | HMO/PPO | $421.40 | $785.46 | — | 2025-06-28 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | UC Ship | PPO | $422.29 | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | UC Ship | PPO | $422.29 | $1,045.28 | $574.90 | 2026-03-29 | MRF ↗ |
| SHANDS JACKSONVILLE BothFacility | BCBS | PPO | $426.40 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE BothFacility | BCBS | CUF | $426.40 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE BothFacility | BCBS | NWB | $426.40 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE BothFacility | BCBS | PPO | $426.40 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE BothFacility | BCBS | JUF | $426.40 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE BothFacility | BCBS | NWB | $426.40 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE BothFacility | BCBS | CUF | $426.40 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE BothFacility | BCBS | JUF | $426.40 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| FLAGLER HOSPITAL OutpatientFacility | BCBS | Simply Blue | $429.65 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| FLAGLER HOSPITAL OutpatientFacility | BCBS | PPO | $429.65 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| FLAGLER HOSPITAL OutpatientFacility | BCBS | PHS | $429.65 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| FLAGLER HOSPITAL OutpatientFacility | BCBS | Network Blue | $429.65 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | HAP | Fully Insured | $429.96 | $785.46 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL BothFacility | Priority Health | HMO/PPO | $431.45 | $785.46 | — | 2025-06-28 | MRF ↗ |
| SHANDS JACKSONVILLE BothFacility | Simply Healthcare | MCD HMO | $433.99 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| UF HEALTH SHANDS HOSPITAL OutpatientFacility | Aetna Better Health | Healthy Kids | $433.99 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | Aetna Better Health | Healthy Kids | $433.99 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | AMBETTER | ALL PRODUCTS | $433.99 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| UF HEALTH SHANDS HOSPITAL OutpatientFacility | Aetna Better Health | Medicaid HMO | $433.99 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | Aetna Better Health | MEDICAID HMO | $433.99 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | MOLINA | MEDICAID HMO | $433.99 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| UF HEALTH SHANDS HOSPITAL BothFacility | Simply Healthcare | MCD HMO | $433.99 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE BothFacility | Simply Healthcare | MCD HMO | $433.99 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| UF HEALTH SHANDS HOSPITAL OutpatientFacility | Ambetter | All Products | $433.99 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| UF HEALTH SHANDS HOSPITAL OutpatientFacility | Devoted Health Plan | Medicare PPO | $433.99 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| UF HEALTH SHANDS HOSPITAL OutpatientFacility | Sunshine State Health Plan | Medicaid HMO | $433.99 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE BothFacility | Simply Healthcare | Fl Healthy Kids | $433.99 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | Devoted Health Plan | Medicare PPO | $433.99 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | Devoted Health Plan | MEDICARE HMO | $433.99 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| UF HEALTH SHANDS HOSPITAL OutpatientFacility | Devoted Health Plan | Medicare HMO | $433.99 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | MOLINA | MEDICAID HMO | $433.99 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| UF HEALTH SHANDS HOSPITAL OutpatientFacility | Humana | MANAGED MEDICAID | $433.99 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | Devoted Health Plan | Medicare PPO | $433.99 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | Aetna Better Health | MEDICAID HMO | $433.99 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | Aetna Better Health | Healthy Kids | $433.99 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | Devoted Health Plan | MEDICARE HMO | $433.99 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| UF HEALTH SHANDS HOSPITAL OutpatientFacility | Molina | Medicaid HMO | $433.99 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| FLAGLER HOSPITAL OutpatientFacility | Aetna | Managed Medicaid | $433.99 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | AMBETTER | ALL PRODUCTS | $433.99 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE BothFacility | Simply Healthcare | Fl Healthy Kids | $433.99 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| UF HEALTH SHANDS HOSPITAL OutpatientFacility | AmeriHealth Caritas Florida | Medicaid HMO | $433.99 | $1,084.98 | $596.74 | 2026-03-31 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Humana | Healthy Horizons Medicaid Transplant Agre | — | $1,152.44 | $115.24 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Cigna Health | Ppo Payor Solutions/Strategic Allia | — | $1,152.44 | $115.24 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Humana | Commercial Ppo | — | $1,152.44 | $115.24 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Humana | Medicare Advantage | — | $1,152.44 | $115.24 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | United Healthcare | Medicare Advantage | — | $1,152.44 | $115.24 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | United Healthcare | All Payer Appendix | — | $1,152.44 | $115.24 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Humana | Healthy Horizons Medicaid | — | $1,152.44 | $115.24 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Aetna Better Health | Managed Medicaid | — | $1,152.44 | $115.24 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Wellpath | Governmental | — | $1,152.44 | $115.24 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Aetna Health | Hmo | — | $1,152.44 | $115.24 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Aetna Health | Open Choice Ppo | $448.00 | $1,152.44 | $115.24 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Aetna Health | National Advantage Program | — | $1,152.44 | $115.24 | 2026-07-18 | MRF ↗ |
Showing the first 200 rate rows. The CSV export above returns up to 1,000 rows — filter by state to narrow a code with more than that.