00069814020 — Xalkori Ds 250mg Cap
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). XALKORI DS 250MG CAP (NDC 00069814020) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/00069814020?code_type=NDC
MLA (9th ed.)
“XALKORI DS 250MG CAP (NDC 00069814020) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/00069814020?code_type=NDC. Accessed .
Chicago (notes-bibliography)
“XALKORI DS 250MG CAP (NDC 00069814020) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/00069814020?code_type=NDC.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $878–$1,327 (25th–75th percentile) across 13 hospitals · 146 payers.
“Negotiated” is the hospital’s negotiated facility rate for this NDC 00069814020 — 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 |
|---|---|---|---|---|---|---|---|
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | INTEL | ALL PRODUCTS | $179.42 | $448.55 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | HEALTHCOMP | ALL PRODUCTS | $179.42 | $448.55 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | CIGNA SELECT | ALL PRODUCTS | $187.05 | $448.55 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | CIGNA | SUREFIT | $188.39 | $448.55 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | UHC | NAVIGATE | $195.12 | $448.55 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AETNA | ALL PRODUCTS | $205.44 | $448.55 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | CIGNA | ALL PRODUCTS | $211.72 | $448.55 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | UHC | NON OPTIONS | $212.16 | $448.55 | — | 2026-01-01 | MRF ↗ |
| NORTHSIDE HOSPITAL CHEROKEE Outpatient | Institutional GA Medicaid | Institutional GA Medicaid | $218.12 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL CHEROKEE Outpatient | Centene | Peach State Medicaid | $218.12 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL CHEROKEE Outpatient | Amerigroup | Amerigroup Medicaid | $218.12 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL CHEROKEE Outpatient | CareSource | CareSource | $224.66 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL FORSYTH Outpatient | Centene | Peach State Medicaid | $235.15 | $1,951.50 | $1,463.63 | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL FORSYTH Outpatient | Amerigroup | Amerigroup Medicaid | $235.15 | $1,951.50 | $1,463.63 | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL FORSYTH Outpatient | Institutional GA Medicaid | Institutional GA Medicaid | $235.15 | $1,951.50 | $1,463.63 | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL FORSYTH Outpatient | CareSource | CareSource | $242.20 | $1,951.50 | $1,463.63 | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL DULUTH Outpatient | Centene | Peach State Medicaid | $246.50 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL DULUTH Outpatient | Institutional GA Medicaid | Institutional GA Medicaid | $246.50 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL DULUTH Outpatient | Institutional Gwinnett County Govt | Institutional Gwinnett County Govt | $246.50 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL DULUTH Outpatient | Amerigroup | Amerigroup Medicaid | $246.50 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL CHEROKEE Outpatient | Institutional 115 Percent_Georgia Medicaid | Institutional 115 Percent_Georgia Medicaid | $250.83 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL DULUTH Outpatient | CareSource | CareSource | $253.89 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL FORSYTH Outpatient | Institutional 115 Percent_Georgia Medicaid | Institutional 115 Percent_Georgia Medicaid | $270.42 | $1,951.50 | $1,463.63 | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL FORSYTH Outpatient | Amerigroup | Amerigroup Medicare Advantage | $277.60 | $1,951.50 | $1,463.63 | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL FORSYTH Outpatient | Cigna | CIGNA HealthSprings Medicare Advantage | $280.26 | $1,951.50 | $1,463.63 | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL DULUTH Outpatient | Institutional 115 Percent_Georgia Medicaid | Institutional 115 Percent_Georgia Medicaid | $283.47 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL CHEROKEE Outpatient | Amerigroup | Amerigroup Medicare Advantage | $289.58 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL BothFacility | ANTIDOTE | ALL PRODUCTS | $291.56 | $448.55 | — | 2026-01-01 | MRF ↗ |
| NORTHSIDE HOSPITAL CHEROKEE Outpatient | Cigna | CIGNA HealthSprings Medicare Advantage | $292.36 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL GWINNETT Outpatient | Amerigroup | Amerigroup Medicare Advantage | $293.57 | $1,951.50 | $1,463.63 | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL GWINNETT Outpatient | Cigna | CIGNA HealthSprings Medicare Advantage | $296.39 | $1,951.50 | $1,463.63 | 2026-02-15 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL BothFacility | CIGNA | TXP LIFESOURCE TRANSPLANT | $312.19 | $448.55 | — | 2026-01-01 | MRF ↗ |
| NORTHSIDE HOSPITAL Outpatient | Amerigroup | Amerigroup Medicare Advantage | $315.54 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL Outpatient | Cigna | CIGNA HealthSprings Medicare Advantage | $318.57 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL BothFacility | AETNA | HEALTHEZ | $328.79 | $448.55 | — | 2026-01-01 | MRF ↗ |
| NORTHSIDE HOSPITAL DULUTH Outpatient | Amerigroup | Amerigroup Medicare Advantage | $335.51 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL DULUTH Outpatient | Cigna | CIGNA HealthSprings Medicare Advantage | $338.74 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL InpatientFacility | CIGNA | TXP LIFESOURCE TRANSPLANT | $340.45 | $448.55 | — | 2026-01-01 | MRF ↗ |
| NORTHSIDE HOSPITAL GWINNETT Outpatient | Institutional Gwinnett County Govt | Institutional Gwinnett County Govt | $350.43 | $1,951.50 | $1,463.63 | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL GWINNETT Outpatient | Institutional GA Medicaid | Institutional GA Medicaid | $350.43 | $1,951.50 | $1,463.63 | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL GWINNETT Outpatient | Amerigroup | Amerigroup Medicaid | $350.43 | $1,951.50 | $1,463.63 | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL GWINNETT Outpatient | Centene | Peach State Medicaid | $350.43 | $1,951.50 | $1,463.63 | 2026-02-15 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | UCLA Health Medicare Advantage Plan | Medicare Advantage | $352.63 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | TriWest Healthcare Alliance | Other Government | — | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Aetna Medicare | Medicare | $352.63 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | UCLA Health Medicare Advantage Plan | Medicare Advantage | $352.63 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Aetna Medicare | Medicare | $352.63 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | UCLA Health Medicare Advantage Plan | Medicare Advantage | $352.63 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| NORTHSIDE HOSPITAL Outpatient | Centene | Peach State Medicaid | $354.57 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL Outpatient | Institutional GA Medicaid | Institutional GA Medicaid | $354.57 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL Outpatient | Amerigroup | Amerigroup Medicaid | $354.57 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL BothFacility | CIGNA | BEHAVIORAL HEALTH | $358.84 | $448.55 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL BothFacility | MULTIPLAN | ALL PRODUCTS | $358.84 | $448.55 | — | 2026-01-01 | MRF ↗ |
| NORTHSIDE HOSPITAL GWINNETT Outpatient | CareSource | CareSource | $360.94 | $1,951.50 | $1,463.63 | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL FORSYTH Outpatient | Centene | Peach State Medicare | $362.93 | $1,951.50 | $1,463.63 | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL Outpatient | CareSource | CareSource | $365.21 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL CHEROKEE Outpatient | Centene | Peach State Medicare | $374.45 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL GWINNETT Outpatient | Centene | Peach State Medicare | $378.29 | $1,951.50 | $1,463.63 | 2026-02-15 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Gold Coast Health Plan | HMO | $394.95 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Gold Coast Health Plan | HMO | $394.95 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| NORTHSIDE HOSPITAL Outpatient | Centene | Peach State Medicare | $399.42 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL GWINNETT Outpatient | Institutional 115 Percent_Georgia Medicaid | Institutional 115 Percent_Georgia Medicaid | $402.99 | $1,951.50 | $1,463.63 | 2026-02-15 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Anthem Workers Comp | Workers Comp | $404.68 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| NORTHSIDE HOSPITAL Outpatient | Institutional 115 Percent_Georgia Medicaid | Institutional 115 Percent_Georgia Medicaid | $407.76 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | Anthem Vivity, Anthem HMO | HMO-City of LA | $413.43 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Anthem Vivity-Anthem HMO | All Products-HMO | $413.43 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| NORTHSIDE HOSPITAL DULUTH Outpatient | Centene | Peach State Medicare | $418.62 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Humana | Healthy Horizons Medicaid Transplant Agre | — | $1,664.12 | $166.41 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Wellpath | Governmental | — | $1,664.12 | $166.41 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Aetna Health | Managed Choice Pos And Elect Choice | — | $1,664.12 | $166.41 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | United Healthcare | All Payer Appendix | — | $1,664.12 | $166.41 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Humana | Medicare Advantage | — | $1,664.12 | $166.41 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Preferred Communitychoice | Ppo | — | $1,664.12 | $166.41 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Healthsmart Preferred Care | Accel | — | $1,664.12 | $166.41 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Oklahoma Complete Care | Medicare Advantage | — | $1,664.12 | $166.41 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Healthsmart Preferred Care | Ppo | — | $1,664.12 | $166.41 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Healthcare Highways - Commercial - D | 5 | — | $1,664.12 | $166.41 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Healthcare Highways - Commercial - D | 3.1 | — | $1,664.12 | $166.41 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Healthcare Highways - Commercial - D | 2 | — | $1,664.12 | $166.41 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Communitycare | Communitycare Plus | — | $1,664.12 | $166.41 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Healthcare Highways - Commercial - D | 6 | — | $1,664.12 | $166.41 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Healthcare Highways - Commercial -D | 1 | — | $1,664.12 | $166.41 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | United Healthcare | Medicare Advantage | — | $1,664.12 | $166.41 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Cigna Health - C | 20 New Business Network | — | $1,664.12 | $166.41 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Communitycare | Hmo Commercial | — | $1,664.12 | $166.41 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Healthcare Highways - Commercial -D | 4 | — | $1,664.12 | $166.41 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Cigna Health | All Products Except Ppo | — | $1,664.12 | $166.41 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Cigna Health | All Other Ppo | — | $1,664.12 | $166.41 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Blue Cross Blue Shield Of Ok | Blue Plan65 Select | — | $1,664.12 | $166.41 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Cigna Health | Ppo Payor Solutions/Strategic Allia | — | $1,664.12 | $166.41 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER OutpatientFacility | — | — | — | $1,664.12 | $166.41 | 2026-03-25 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Quiktrip | Commercial | — | $1,664.12 | $166.41 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Aetna Health | Hmo | — | $1,664.12 | $166.41 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Blue Cross Blue Shield Of Ok | Nativeblue | — | $1,664.12 | $166.41 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Humana | Commercial Ppo | — | $1,664.12 | $166.41 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Aetna Health | Open Choice Ppo | $448.00 | $1,664.12 | $166.41 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Oklahoma Complete Care | Managed Medicaid | — | $1,664.12 | $166.41 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Ameri-Plus Preferred Care Inc | Medicare Advantage | — | $1,664.12 | $166.41 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Humana | Healthy Horizons Medicaid | — | $1,664.12 | $166.41 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Aetna Better Health | Managed Medicaid | — | $1,664.12 | $166.41 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Aetna Health | National Advantage Program | — | $1,664.12 | $166.41 | 2026-07-18 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Anthem Vivity, Anthem HMO | HMO-City of LA | $458.70 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | UC Care - PPO | PPO | $462.65 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Anthem Vivity, Anthem HMO | HMO-NonCity of LA | $465.33 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | UC Ship | PPO | $473.94 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | UC Ship | PPO | $473.94 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Health Care LA - RMG | All Products | $493.69 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Health Care LA MediCal - RMG | Medicaid Advantage | $493.69 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | CenCal Medi-Cal HMO | Medi-Cal HMO | $493.69 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Providence Healthcare | Medicare | $493.69 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Providence Healthcare | Medicare | $493.69 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | CenCal Transplant Medi-Cal HMO | Medi-Cal HMO | $493.69 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Health Care LA MediCal - RMG | Medicaid Advantage | $493.69 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Blue Shield | Medicare Advantage | $493.69 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Health Care LA - RMG | All Products | $493.69 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Blue Shield | Medicare Advantage | $493.69 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Anthem Vivity, Anthem HMO | HMO-NonCity of LA | $516.82 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | Anthem Vivity, Anthem HMO | HMO-NonCity of LA | $516.82 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| NORTHSIDE HOSPITAL CHEROKEE Outpatient | BCBS | BCBS_PATHWAY | $545.25 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL Outpatient | BCBS | BCBS_PATHWAY-L | $545.25 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL Outpatient | BCBS | BCBS_PATHWAY | $545.25 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL FORSYTH Outpatient | BCBS | BCBS_PATHWAY-L | $545.25 | $1,951.50 | $1,463.63 | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL GWINNETT Outpatient | BCBS | BCBS_PATHWAY-L | $545.25 | $1,951.50 | $1,463.63 | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL CHEROKEE Outpatient | BCBS | BCBS_PATHWAY-L | $545.25 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL FORSYTH Outpatient | BCBS | BCBS_PATHWAY | $545.25 | $1,951.50 | $1,463.63 | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL DULUTH Outpatient | BCBS | BCBS_PATHWAY-L | $545.25 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL GWINNETT Outpatient | BCBS | BCBS_PATHWAY | $545.25 | $1,951.50 | $1,463.63 | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL DULUTH Outpatient | BCBS | BCBS_PATHWAY | $545.25 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | UC Care - PPO | PPO | $551.52 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Molina Healthcare HMO | MediCal HMO | $564.21 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | UCI University - RMG | All Products | $564.21 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Children Hospital of Orange County | Medicaid HMO | $564.21 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | UCI University - RMG | All Products | $564.21 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | LA care Medi-Cal HMO | Medi-Cal HMO | $564.21 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | LA care Medi-Cal HMO | Medi-Cal HMO | $564.21 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Molina Healthcare HMO | MediCal HMO | $564.21 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Children Hospital of Orange County | Medicaid HMO | $564.21 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | UC Ship | PPO | $569.85 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | UC Ship | PPO | $569.85 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | UC Ship | PPO | $670.00 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Kaiser | Medicare | $712.32 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Kaiser | All Products | $712.32 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Kaiser | All Products | $712.32 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Kaiser | Medicare | $712.32 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| NORTHSIDE HOSPITAL Inpatient | CareSource | CareSource MarketPlace | $725.96 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL DULUTH Inpatient | CareSource | CareSource MarketPlace | $725.96 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL CHEROKEE Inpatient | CareSource | CareSource MarketPlace | $725.96 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL FORSYTH Inpatient | CareSource | CareSource MarketPlace | $725.96 | $1,951.50 | $1,463.63 | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL GWINNETT Inpatient | CareSource | CareSource MarketPlace | $725.96 | $1,951.50 | $1,463.63 | 2026-02-15 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | SCAN | Medicare | $770.15 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | Aetna Medicare | Medicare | $770.15 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | Blue Shield | Medicare Advantage | $770.15 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | LA Care Covered CA | HMO | $775.79 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | HealthCare Partners HMO | HMO-Medicare | $775.79 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | LA Care DSNP | Medicare HMO | $775.79 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Optum | Medicare | $775.79 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Optum | Medicare | $775.79 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | HealthCare Partners HMO | HMO-Medicare | $775.79 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | LA Care Covered CA | HMO | $775.79 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | LA Care DSNP | Medicare HMO | $775.79 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| NORTHSIDE HOSPITAL CHEROKEE Outpatient | MedLien Healthcare Services | MedLien Healthcare Services | $780.60 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL FORSYTH Inpatient | Georgia Reproductive Specialists | Georgia Reproductive Specialists (SGF) | $780.60 | $1,951.50 | $1,463.63 | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL CHEROKEE Inpatient | Georgia Reproductive Specialists | Georgia Reproductive Specialists (SGF) | $780.60 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL Outpatient | MedLien Healthcare Services | MedLien Healthcare Services | $780.60 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL Inpatient | Georgia Reproductive Specialists | Georgia Reproductive Specialists (SGF) | $780.60 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL DULUTH Outpatient | MedLien Healthcare Services | MedLien Healthcare Services | $780.60 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL FORSYTH Outpatient | MedLien Healthcare Services | MedLien Healthcare Services | $780.60 | $1,951.50 | $1,463.63 | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL DULUTH Inpatient | Georgia Reproductive Specialists | Georgia Reproductive Specialists (SGF) | $780.60 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL GWINNETT Inpatient | Georgia Reproductive Specialists | Georgia Reproductive Specialists (SGF) | $780.60 | $1,951.50 | $1,463.63 | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL GWINNETT Outpatient | MedLien Healthcare Services | MedLien Healthcare Services | $780.60 | $1,951.50 | $1,463.63 | 2026-02-15 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Health Net B&G | HMO | $788.49 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Kaiser | All Products | $789.90 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Kaiser | All Products | $789.90 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | Kaiser | All Products | $804.00 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Redlands Community General Services | HMO | $818.11 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Redlands Community General Services | HMO | $818.11 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Cigna | PPO | $825.30 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Cigna | HMO | $825.30 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Cigna | PPO | $825.30 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Cigna | HMO | $825.30 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| NORTHSIDE HOSPITAL Outpatient | BCBS | Blue HPN | $843.63 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL Outpatient | BCBS | Blue HPN-L | $843.63 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL CHEROKEE Outpatient | BCBS | Blue HPN | $843.63 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL FORSYTH Outpatient | BCBS | Blue HPN-L | $843.63 | $1,951.50 | $1,463.63 | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL FORSYTH Outpatient | BCBS | Blue HPN | $843.63 | $1,951.50 | $1,463.63 | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL DULUTH Outpatient | BCBS | Blue HPN-L | $843.63 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL CHEROKEE Outpatient | BCBS | Blue HPN-L | $843.63 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL DULUTH Outpatient | BCBS | Blue HPN | $843.63 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL GWINNETT Outpatient | BCBS | Blue HPN-L | $843.63 | $1,951.50 | $1,463.63 | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL GWINNETT Outpatient | BCBS | Blue HPN | $843.63 | $1,951.50 | $1,463.63 | 2026-02-15 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Blue Shield | EPN | $846.32 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Blue Shield | EPN | $846.32 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| NORTHSIDE HOSPITAL Outpatient | Med Care Solutions | Med Care Solutions | $878.18 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL FORSYTH Outpatient | Med Care Solutions | Med Care Solutions | $878.18 | $1,951.50 | $1,463.63 | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL DULUTH Outpatient | Med Care Solutions | Med Care Solutions | $878.18 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL GWINNETT Outpatient | Med Care Solutions | Med Care Solutions | $878.18 | $1,951.50 | $1,463.63 | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL CHEROKEE Outpatient | Med Care Solutions | Med Care Solutions | $878.18 | $1,951.50 | $1,463.63 | 2026-02-14 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Health Plan of Nevada Commercial | All Products | $902.74 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Health Plan of Nevada Commercial | All Products | $902.74 | $1,410.53 | $775.79 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Valley Care - RMG | All Products | $916.84 | $1,410.53 | $775.79 | 2026-03-29 | 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.