0200T — Perq Sacral Augmt Unilat Inj
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). Perq sacral augmt unilat inj (OTHER 0200T) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/0200T?code_type=OTHER
MLA (9th ed.)
“Perq sacral augmt unilat inj (OTHER 0200T) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/0200T?code_type=OTHER. Accessed .
Chicago (notes-bibliography)
“Perq sacral augmt unilat inj (OTHER 0200T) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/0200T?code_type=OTHER.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $4,285–$9,335 (25th–75th percentile) across 702 hospitals · 1,310 payers.
“Negotiated” is the hospital’s negotiated facility rate for this OTHER 0200T — 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 |
|---|---|---|---|---|---|---|---|
| CAROLINA EAST MEDICAL CENTER Outpatient | AETNA-ALL PLANS | AETNA-ALL PLANS | $4.00 | $7,092.00 | $4,255.20 | 2026-07-17 | MRF ↗ |
| RARITAN BAY MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $22.89 | $12,714.00 | $7,262.33 | 2024-12-31 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Outpatient | UHC COMM-ALL OTHER PLANS | UHC COMM-ALL OTHER PLANS | $37.40 | $187.00 | $140.25 | 2026-04-27 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Outpatient | PHCS-ALL PLANS | PHCS-ALL PLANS | $63.00 | $187.00 | $140.25 | 2026-04-27 | MRF ↗ |
| MADISON COUNTY HEALTH CARE SYSTEM Outpatient | MIDLANDS CHOICE - ALL PLANS | MIDLANDS CHOICE - ALL PLANS | $63.50 | $443.00 | $354.40 | 2026-06-05 | MRF ↗ |
| ADVENTIST HEALTH BAKERSFIELD Outpatient | BLUE CROSS NON-MCS - ALL OTHER PLANS | BLUE CROSS NON-MCS - ALL OTHER PLANS | $75.60 | $3,014.00 | $452.10 | 2026-10-05 | MRF ↗ |
| ADVENTIST HEALTH BAKERSFIELD Outpatient | BLUE CROSS MCS | BLUE CROSS MCS | $75.60 | $3,014.00 | $452.10 | 2026-10-05 | MRF ↗ |
| BELLEVUE MEDICAL CENTER Outpatient | AETNA COMM-ALL OTHER PLANS | AETNA COMM-ALL OTHER PLANS | $78.57 | $1,662.30 | $1,080.50 | 2026-08-10 | MRF ↗ |
| SHERIDAN MEMORIAL HOSPITAL Outpatient | BLUE CROSS WYOMING-ALL PLANS | BLUE CROSS WYOMING-ALL PLANS | $80.00 | $1,950.00 | $1,560.00 | 2026-10-02 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Outpatient | CIGNA-ALL PLANS | CIGNA-ALL PLANS | $93.50 | $187.00 | $140.25 | 2026-04-27 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Outpatient | HEALTH NET | HEALTH NET | $93.50 | $187.00 | $140.25 | 2026-04-27 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Outpatient | COVENTRY/FIRST HEALTH-ALL PLANS | COVENTRY/FIRST HEALTH-ALL PLANS | $130.90 | $187.00 | $140.25 | 2026-04-27 | MRF ↗ |
| ST DOMINIC-JACKSON MEMORIAL HOSPITAL Outpatient | UHC NEXUS | UHC NEXUS | $160.00 | $9,703.00 | $4,851.50 | 2026-01-17 | MRF ↗ |
| ST DOMINIC-JACKSON MEMORIAL HOSPITAL Outpatient | UHC EXCHANGE | UHC EXCHANGE | $162.00 | $9,703.00 | $4,851.50 | 2026-01-17 | MRF ↗ |
| ST DOMINIC-JACKSON MEMORIAL HOSPITAL Outpatient | UHC - ALL OTHER PLANS | UHC - ALL OTHER PLANS | $178.00 | $9,703.00 | $4,851.50 | 2026-01-17 | MRF ↗ |
| CENTINELA HOSPITAL MEDICAL CENTER Outpatient | IN CUSTODY | In Custody | $200.00 | $16,819.30 | $11,620.00 | 2024-12-19 | MRF ↗ |
| MADISON COUNTY HEALTH CARE SYSTEM Outpatient | MADISON COUNTY SHERIFF-ALL PLANS | MADISON COUNTY SHERIFF-ALL PLANS | $221.50 | $443.00 | $354.40 | 2026-06-05 | MRF ↗ |
| UM Capital Region Medical Center OutpatientFacility | United Healthcare | Custom | $243.00 | $8,192.00 | $4,915.20 | 2025-12-15 | MRF ↗ |
| KEARNEY REGIONAL MEDICAL CENTER Outpatient | WELLCARE OF NEBRASKA MCAID-ALL PLANS | WELLCARE OF NEBRASKA MCAID-ALL PLANS | $257.08 | $3,813.00 | $2,669.10 | 2025-07-17 | MRF ↗ |
| KEARNEY REGIONAL MEDICAL CENTER Outpatient | ARBOR HEALTH PLAN MCAID-ALL PLANS | ARBOR HEALTH PLAN MCAID-ALL PLANS | $257.08 | $3,813.00 | $2,669.10 | 2025-07-17 | MRF ↗ |
| UM Capital Region Medical Center OutpatientFacility | United Healthcare | Customer Specific | $276.00 | $8,192.00 | $4,915.20 | 2025-12-15 | MRF ↗ |
| UM Capital Region Medical Center OutpatientFacility | United Healthcare | Direct PPO | $280.00 | $8,192.00 | $4,915.20 | 2025-12-15 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | BLUE SHIELD EPN | BLUE SHIELD EPN | $288.19 | $912.00 | $173.28 | 2026-05-22 | MRF ↗ |
| UM Capital Region Medical Center OutpatientFacility | United Healthcare | PPO/HMO | $300.00 | $8,192.00 | $4,915.20 | 2025-12-15 | MRF ↗ |
| CASS COUNTY MEMORIAL HOSPITAL Outpatient | MIDLANDS CHOICE MEDICA MCR | MIDLANDS CHOICE MEDICA MCR | $309.00 | $1,545.00 | $1,081.50 | 2026-06-01 | MRF ↗ |
| MADISON COUNTY HEALTH CARE SYSTEM Outpatient | MEDIMORE EMPLOYEE HP - ALL PLANS | MEDIMORE EMPLOYEE HP - ALL PLANS | $354.40 | $443.00 | $354.40 | 2026-06-05 | MRF ↗ |
| MADISON COUNTY HEALTH CARE SYSTEM Outpatient | CHOICECARE-ALL PLANS | CHOICECARE-ALL PLANS | $354.40 | $443.00 | $354.40 | 2026-06-05 | MRF ↗ |
| UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER OutpatientFacility | Ufcw | Ucd Hb Blue Shield Referred | $361.76 | — | — | 2026-04-01 | MRF ↗ |
| UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER OutpatientFacility | Blue Shield | Ucd Hb Blue Shield Ifp | $361.76 | — | — | 2026-04-01 | MRF ↗ |
| UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER OutpatientFacility | Blue Shield | Ucd Hb Blue Shield Calpers | $361.76 | — | — | 2026-04-01 | MRF ↗ |
| UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER OutpatientFacility | Pipe Trades | Ucd Hb Blue Shield Referred | $361.76 | — | — | 2026-04-01 | MRF ↗ |
| UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER OutpatientFacility | Blue Shield | Ucd Hb Blue Shield Referred | $361.76 | — | — | 2026-04-01 | MRF ↗ |
| UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER OutpatientFacility | Sheet Metal Workers Union(Smw) | Ucd Hb Blue Shield Referred | $361.76 | — | — | 2026-04-01 | MRF ↗ |
| MADISON COUNTY HEALTH CARE SYSTEM Outpatient | AETNA MCR ADV | AETNA MCR ADV | $367.22 | $854.00 | $683.20 | 2026-06-05 | MRF ↗ |
| MADISON COUNTY HEALTH CARE SYSTEM Outpatient | MEDIGOLD-ALL PLANS | MEDIGOLD-ALL PLANS | $367.22 | $854.00 | $683.20 | 2026-06-05 | MRF ↗ |
| MADISON COUNTY HEALTH CARE SYSTEM Outpatient | UHC MCR ADV | UHC MCR ADV | $367.22 | $854.00 | $683.20 | 2026-06-05 | MRF ↗ |
| MADISON COUNTY HEALTH CARE SYSTEM Outpatient | TRICARE/HNFS - ALL PLANS | TRICARE/HNFS - ALL PLANS | $367.22 | $854.00 | $683.20 | 2026-06-05 | MRF ↗ |
| MADISON COUNTY HEALTH CARE SYSTEM Outpatient | MEDICAL ASSOCIATES HP - ALL PLANS | MEDICAL ASSOCIATES HP - ALL PLANS | $367.22 | $854.00 | $683.20 | 2026-06-05 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Outpatient | HUMANA CHOICE CARE ONE | HUMANA CHOICE CARE ONE | $382.17 | $187.00 | $140.25 | 2026-04-27 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Outpatient | HUMANA CHOICE CARE-ALL OTHER PLANS | HUMANA CHOICE CARE-ALL OTHER PLANS | $382.17 | $187.00 | $140.25 | 2026-04-27 | MRF ↗ |
| MADISON COUNTY HEALTH CARE SYSTEM Outpatient | AMERICAN HP MCR ADV-ALL PLANS | AMERICAN HP MCR ADV-ALL PLANS | $385.58 | $854.00 | $683.20 | 2026-06-05 | MRF ↗ |
| ADVENTIST HEALTH BAKERSFIELD Outpatient | BLUE SHIELD EPN | BLUE SHIELD EPN | $386.13 | $3,014.00 | $452.10 | 2026-10-05 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | BLUE SHIELD-ALL OTHER PLANS | BLUE SHIELD-ALL OTHER PLANS | $398.54 | $912.00 | $173.28 | 2026-05-22 | MRF ↗ |
| MADISON COUNTY HEALTH CARE SYSTEM Outpatient | CORVEL WC-ALL PLANS | CORVEL WC-ALL PLANS | $398.70 | $443.00 | $354.40 | 2026-06-05 | MRF ↗ |
| MADISON COUNTY HEALTH CARE SYSTEM Outpatient | IOWA TOTAL CARE MCAID-ALL PLANS | IOWA TOTAL CARE MCAID-ALL PLANS | $401.38 | $854.00 | $683.20 | 2026-06-05 | MRF ↗ |
| MADISON COUNTY HEALTH CARE SYSTEM Outpatient | UHC MCAID | UHC MCAID | $401.38 | $854.00 | $683.20 | 2026-06-05 | MRF ↗ |
| ADVENTIST HEALTH BAKERSFIELD Outpatient | BLUE SHIELD EPO/PPO | BLUE SHIELD EPO/PPO | $408.05 | $3,014.00 | $452.10 | 2026-10-05 | MRF ↗ |
| ADVENTIST HEALTH BAKERSFIELD Outpatient | BLUE SHIELD HMO/POS - ALL OTHER PLANS | BLUE SHIELD HMO/POS - ALL OTHER PLANS | $408.05 | $3,014.00 | $452.10 | 2026-10-05 | MRF ↗ |
| SAINT AGNES MEDICAL CENTER OutpatientFacility | BSCA | EPN | $415.30 | $3,400.00 | $2,380.00 | 2025-01-01 | MRF ↗ |
| MADISON COUNTY HEALTH CARE SYSTEM Outpatient | MOLINA MCAID/CHIP -ALL PLANS | MOLINA MCAID/CHIP -ALL PLANS | $415.47 | $854.00 | $683.20 | 2026-06-05 | MRF ↗ |
| MADISON COUNTY HEALTH CARE SYSTEM Outpatient | FIRST HEALTH-ALL PLANS | FIRST HEALTH-ALL PLANS | $420.85 | $443.00 | $354.40 | 2026-06-05 | MRF ↗ |
| MADISON COUNTY HEALTH CARE SYSTEM Outpatient | FIRST CHOICE-ALL PLANS | FIRST CHOICE-ALL PLANS | $420.85 | $443.00 | $354.40 | 2026-06-05 | MRF ↗ |
| MADISON COUNTY HEALTH CARE SYSTEM Outpatient | PLAINES HEALTH-ALL PLANS | PLAINES HEALTH-ALL PLANS | $420.85 | $443.00 | $354.40 | 2026-06-05 | MRF ↗ |
| MADISON COUNTY HEALTH CARE SYSTEM Outpatient | PREFERRED HLTH NTWORK-ALL PLANS | PREFERRED HLTH NTWORK-ALL PLANS | $420.85 | $443.00 | $354.40 | 2026-06-05 | MRF ↗ |
| MADISON COUNTY HEALTH CARE SYSTEM Outpatient | USA MANAGED CARE-ALL PLANS | USA MANAGED CARE-ALL PLANS | $420.85 | $443.00 | $354.40 | 2026-06-05 | MRF ↗ |
| MADISON COUNTY HEALTH CARE SYSTEM Outpatient | PRINCIPAL HEALTHCARE-ALL PLANS | PRINCIPAL HEALTHCARE-ALL PLANS | $420.85 | $443.00 | $354.40 | 2026-06-05 | MRF ↗ |
| MADISON COUNTY HEALTH CARE SYSTEM Outpatient | INTEGRATED HP-ALL PLANS | INTEGRATED HP-ALL PLANS | $420.85 | $443.00 | $354.40 | 2026-06-05 | MRF ↗ |
| MADISON COUNTY HEALTH CARE SYSTEM Outpatient | MUTUAL OF OMAHA-ALL PLANS | MUTUAL OF OMAHA-ALL PLANS | $420.85 | $443.00 | $354.40 | 2026-06-05 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | CIGNA-ALL PLANS | CIGNA-ALL PLANS | $422.26 | $912.00 | $173.28 | 2026-05-22 | MRF ↗ |
| MADISON COUNTY HEALTH CARE SYSTEM Outpatient | AMERIGROUP MCAID-ALL PLANS | AMERIGROUP MCAID-ALL PLANS | $425.46 | $854.00 | $683.20 | 2026-06-05 | MRF ↗ |
| MADISON COUNTY HEALTH CARE SYSTEM Outpatient | MADISON COUNTY SHERIFF-ALL PLANS | MADISON COUNTY SHERIFF-ALL PLANS | $427.00 | $854.00 | $683.20 | 2026-06-05 | MRF ↗ |
| MADISON COUNTY HEALTH CARE SYSTEM Outpatient | UHC MCAID | UHC MCAID | $443.00 | $443.00 | $354.40 | 2026-06-05 | MRF ↗ |
| MADISON COUNTY HEALTH CARE SYSTEM Outpatient | IOWA TOTAL CARE MCAID-ALL PLANS | IOWA TOTAL CARE MCAID-ALL PLANS | $443.00 | $443.00 | $354.40 | 2026-06-05 | MRF ↗ |
| MADISON COUNTY HEALTH CARE SYSTEM Outpatient | BENEFIT ADMIN OF AMERICA-ALL PLANS | BENEFIT ADMIN OF AMERICA-ALL PLANS | $443.00 | $443.00 | $354.40 | 2026-06-05 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Bcbs | Bcwyn Medicare Managed Care Plan | $449.72 | — | — | 2026-04-01 | MRF ↗ |
| MADISON COUNTY HEALTH CARE SYSTEM Outpatient | MOLINA MCAID/CHIP -ALL PLANS | MOLINA MCAID/CHIP -ALL PLANS | $454.08 | $443.00 | $354.40 | 2026-06-05 | MRF ↗ |
| KUAKINI MEDICAL CENTER OutpatientFacility | UHC | QUEST INT | $456.03 | $2,379.50 | $2,141.55 | 2026-01-25 | MRF ↗ |
| DEKALB COMMUNITY HOSPITAL Outpatient | BCBS BLUE CARE (REGIONALS ONLY) | 2428_BCBS BLUE CARE (DEKALB) 20221001 | $456.77 | — | — | 2026-01-01 | MRF ↗ |
| SAINT THOMAS RUTHERFORD HOSPITAL Outpatient | BCBS TENNCARE SELECT | 2414_BCBS BLUE CARE TENNCARE (RUTHERFORD) 20221001 | $456.77 | — | — | 2026-01-01 | MRF ↗ |
| Ascension Saint Thomas Hickman Outpatient | BCBS BLUE CARE (REGIONALS ONLY) | 2429_BCBS BLUE CARE (HIGHLAND) 20221001 | $456.77 | — | — | 2026-01-01 | MRF ↗ |
| Ascension Saint Thomas Hospital Midtown Outpatient | BCBS BLUE CARE | 1015_BCBS BLUE CARE TENNCARE SELECT 20221001 | $456.77 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION SAINT THOMAS HOSPITAL Outpatient | BCBS TENNCARE SELECT | 2423_BCBS BLUE CARE TENNCARE (WEST) 20221001 | $456.77 | $20,724.75 | $6,217.43 | 2026-01-01 | MRF ↗ |
| ASCENSION SAINT THOMAS THREE RIVERS Outpatient | BCBS BLUE CARE (REGIONALS ONLY) | 2431_BCBS BLUE CARE (STONES RIVER) 20221001 | $456.77 | — | — | 2026-01-01 | MRF ↗ |
| MADISON COUNTY HEALTH CARE SYSTEM Outpatient | AMERIGROUP MCAID-ALL PLANS | AMERIGROUP MCAID-ALL PLANS | $469.58 | $443.00 | $354.40 | 2026-06-05 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | UHC JLL | UHC JLL | $498.32 | $912.00 | $173.28 | 2026-05-22 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Outpatient | ANTHEM PATHWAY X | 9405_ANTHEM PATHWAY X VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Outpatient | ANTHEM PPO PREFERRED | 9406_ANTHEM PREFERRED VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | PATOKA VALLEY TIER 2 | 9415_PAKOTA VALLEY TIER 2 VEIN 20250101 | $499.00 | $9,592.00 | $5,755.20 | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Outpatient | ANTHEM PATHWAY X | 9405_ANTHEM PATHWAY X VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | ANTHEM SHORT TERM LIMITED DURATION | 9407_ANTHEM SHORT TERM LIMITED DURATION VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Outpatient | ENCORE EXCLUSIVE | 9409_ENCORE EXCUSIVE VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | ANTHEM HEALTHSYNC HMO | 9399_ANTHEM HEALTHSYNC HMO VEIN 20250101 | $499.00 | $9,592.00 | $5,755.20 | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Outpatient | PATOKA VALLEY TIER 1 | 9412_PAKOTA VALLEY TIER 1 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | ANTHEM PATHWAY X | 9405_ANTHEM PATHWAY X VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | PATOKA VALLEY TIER 1 | 9410_PAKOTA VALLEY TIER 1 VEIN 20250101 | $499.00 | $9,592.00 | $5,755.20 | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Outpatient | PATOKA VALLEY TIER 1 | 9410_PAKOTA VALLEY TIER 1 VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Outpatient | ANTHEM HMO/POS | 9403_ANTHEM HMO POS VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | PATOKA VALLEY TIER 2 | 9413_PAKOTA VALLEY TIER 2 20250101 | $499.00 | $9,592.00 | $5,755.20 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Outpatient | ANTHEM PATHWAY X | 9405_ANTHEM PATHWAY X VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | ANTHEM PPO PREFERRED | 9406_ANTHEM PREFERRED VEIN 20250101 | $499.00 | $8,871.00 | $5,322.60 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | PATOKA VALLEY TIER 1 | 9412_PAKOTA VALLEY TIER 1 20250101 | $499.00 | $9,592.00 | $5,755.20 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | ANTHEM PATHWAY X | 9405_ANTHEM PATHWAY X VEIN 20250101 | $499.00 | $9,592.00 | $5,755.20 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | ANTHEM PPO PREFERRED | 9406_ANTHEM PREFERRED VEIN 20250101 | $499.00 | $9,592.00 | $5,755.20 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | ANTHEM HMO/POS | 9403_ANTHEM HMO POS VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | ANTHEM PATHWAY | 9404_ANTHEM PATHWAY VEIN 20250101 | $499.00 | $9,592.00 | $5,755.20 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Outpatient | ENCORE EXCLUSIVE | 9409_ENCORE EXCUSIVE VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Outpatient | PATOKA VALLEY TIER 2 | 9413_PAKOTA VALLEY TIER 2 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | PATOKA VALLEY TIER 2 | 9413_PAKOTA VALLEY TIER 2 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | ANTHEM SHORT TERM LIMITED DURATION | 9407_ANTHEM SHORT TERM LIMITED DURATION VEIN 20250101 | $499.00 | $9,592.00 | $5,755.20 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Outpatient | PATOKA VALLEY TIER 2 | 9413_PAKOTA VALLEY TIER 2 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Outpatient | ANTHEM HEALTHSYNC HMO | 9399_ANTHEM HEALTHSYNC HMO VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Outpatient | ANTHEM SHORT TERM LIMITED DURATION | 9407_ANTHEM SHORT TERM LIMITED DURATION VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Outpatient | ANTHEM PPO PREFERRED | 9406_ANTHEM PREFERRED VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | ENCORE EXCLUSIVE | 9409_ENCORE EXCUSIVE VEIN 20250101 | $499.00 | $9,592.00 | $5,755.20 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | ANTHEM SHORT TERM LIMITED DURATION | 9407_ANTHEM SHORT TERM LIMITED DURATION VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | ANTHEM TRADITIONAL | 9408_ANTHEM TRADITIONAL VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | ENCORE EXCLUSIVE | 9409_ENCORE EXCUSIVE VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Outpatient | ANTHEM SHORT TERM LIMITED DURATION | 9407_ANTHEM SHORT TERM LIMITED DURATION VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | ANTHEM HEALTHSYNC POS | 9401_ANTHEM HEALTHSYNC POS VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | ANTHEM HEALTHSYNC POS | 9401_ANTHEM HEALTHSYNC POS VEIN 20250101 | $499.00 | $9,592.00 | $5,755.20 | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Outpatient | PATOKA VALLEY TIER 2 | 9413_PAKOTA VALLEY TIER 2 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | ANTHEM HEALTHSYNC HMO | 9399_ANTHEM HEALTHSYNC HMO VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | ANTHEM PPO PREFERRED | 9406_ANTHEM PREFERRED VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | PATOKA VALLEY TIER 2 | 9415_PAKOTA VALLEY TIER 2 VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | PATOKA VALLEY TIER 2 | 9413_PAKOTA VALLEY TIER 2 20250101 | $499.00 | $8,871.00 | $5,322.60 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | PATOKA VALLEY TIER 1 | 9412_PAKOTA VALLEY TIER 1 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Outpatient | ANTHEM PATHWAY X | 9405_ANTHEM PATHWAY X VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Outpatient | ANTHEM HMO/POS | 9403_ANTHEM HMO POS VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | ANTHEM TRADITIONAL | 9408_ANTHEM TRADITIONAL VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | PATOKA VALLEY TIER 1 | 9412_PAKOTA VALLEY TIER 1 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | ANTHEM HEALTHSYNC HMO | 9399_ANTHEM HEALTHSYNC HMO VEIN 20250101 | $499.00 | $8,871.00 | $5,322.60 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | ENCORE EXCLUSIVE | 9409_ENCORE EXCUSIVE VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | ANTHEM HEALTHSYNC POS | 9401_ANTHEM HEALTHSYNC POS VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Outpatient | ANTHEM PATHWAY | 9404_ANTHEM PATHWAY VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | ANTHEM PATHWAY | 9404_ANTHEM PATHWAY VEIN 20250101 | $499.00 | $8,871.00 | $5,322.60 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | ANTHEM HMO/POS | 9403_ANTHEM HMO POS VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | ANTHEM PATHWAY | 9404_ANTHEM PATHWAY VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | ANTHEM TRADITIONAL | 9408_ANTHEM TRADITIONAL VEIN 20250101 | $499.00 | $8,871.00 | $5,322.60 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | ANTHEM TRADITIONAL | 9408_ANTHEM TRADITIONAL VEIN 20250101 | $499.00 | $9,592.00 | $5,755.20 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | ANTHEM HMO/POS | 9403_ANTHEM HMO POS VEIN 20250101 | $499.00 | $9,592.00 | $5,755.20 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | ANTHEM HEALTHSYNC POS | 9401_ANTHEM HEALTHSYNC POS VEIN 20250101 | $499.00 | $8,871.00 | $5,322.60 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | ANTHEM PATHWAY X | 9405_ANTHEM PATHWAY X VEIN 20250101 | $499.00 | $8,871.00 | $5,322.60 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Outpatient | ENCORE EXCLUSIVE | 9409_ENCORE EXCUSIVE VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Outpatient | PATOKA VALLEY TIER 1 | 9412_PAKOTA VALLEY TIER 1 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Outpatient | ANTHEM PPO PREFERRED | 9406_ANTHEM PREFERRED VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | ANTHEM PPO PREFERRED | 9406_ANTHEM PREFERRED VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Outpatient | PATOKA VALLEY TIER 1 | 9410_PAKOTA VALLEY TIER 1 VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Outpatient | PATOKA VALLEY TIER 1 | 9412_PAKOTA VALLEY TIER 1 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Outpatient | PATOKA VALLEY TIER 2 | 9415_PAKOTA VALLEY TIER 2 VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | ANTHEM PATHWAY X | 9405_ANTHEM PATHWAY X VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | ANTHEM TRADITIONAL | 9408_ANTHEM TRADITIONAL VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | ANTHEM PATHWAY | 9404_ANTHEM PATHWAY VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | PATOKA VALLEY TIER 1 | 9412_PAKOTA VALLEY TIER 1 20250101 | $499.00 | $8,871.00 | $5,322.60 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Outpatient | ANTHEM HEALTHSYNC POS | 9401_ANTHEM HEALTHSYNC POS VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Outpatient | ANTHEM PATHWAY | 9404_ANTHEM PATHWAY VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Outpatient | ANTHEM HEALTHSYNC HMO | 9399_ANTHEM HEALTHSYNC HMO VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | PATOKA VALLEY TIER 1 | 9410_PAKOTA VALLEY TIER 1 VEIN 20250101 | $499.00 | $8,871.00 | $5,322.60 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | PATOKA VALLEY TIER 2 | 9413_PAKOTA VALLEY TIER 2 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Outpatient | ANTHEM PATHWAY | 9404_ANTHEM PATHWAY VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Outpatient | ANTHEM TRAD - ALL OTHER PLANS | ANTHEM TRAD - ALL OTHER PLANS | $499.00 | $187.00 | $140.25 | 2026-04-27 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Outpatient | ANTHEM PPO | ANTHEM PPO | $499.00 | $187.00 | $140.25 | 2026-04-27 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Outpatient | PATOKA VALLEY TIER 2 | 9415_PAKOTA VALLEY TIER 2 VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | ENCORE EXCLUSIVE | 9409_ENCORE EXCUSIVE VEIN 20250101 | $499.00 | $8,871.00 | $5,322.60 | 2026-01-01 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Outpatient | ANTHEM PATH ESSENTIALS | ANTHEM PATH ESSENTIALS | $499.00 | $187.00 | $140.25 | 2026-04-27 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Outpatient | PATOKA VALLEY TIER 1 | 9410_PAKOTA VALLEY TIER 1 VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Outpatient | ANTHEM SHORT TERM LIMITED DURATION | 9407_ANTHEM SHORT TERM LIMITED DURATION VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Outpatient | ANTHEM PATH X | ANTHEM PATH X | $499.00 | $187.00 | $140.25 | 2026-04-27 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Outpatient | ANTHEM HMO | ANTHEM HMO | $499.00 | $187.00 | $140.25 | 2026-04-27 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | ANTHEM HEALTHSYNC HMO | 9399_ANTHEM HEALTHSYNC HMO VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | PATOKA VALLEY TIER 2 | 9415_PAKOTA VALLEY TIER 2 VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Outpatient | ANTHEM TRADITIONAL | 9408_ANTHEM TRADITIONAL VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | ANTHEM TRADITIONAL | 9408_ANTHEM TRADITIONAL VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Outpatient | ANTHEM HEALTHSYNC POS | 9401_ANTHEM HEALTHSYNC POS VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | ANTHEM HEALTHSYNC HMO | 9399_ANTHEM HEALTHSYNC HMO VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | ENCORE EXCLUSIVE | 9409_ENCORE EXCUSIVE VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | PATOKA VALLEY TIER 2 | 9415_PAKOTA VALLEY TIER 2 VEIN 20250101 | $499.00 | $8,871.00 | $5,322.60 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | PATOKA VALLEY TIER 1 | 9410_PAKOTA VALLEY TIER 1 VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | ANTHEM PPO PREFERRED | 9406_ANTHEM PREFERRED VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | PATOKA VALLEY TIER 2 | 9415_PAKOTA VALLEY TIER 2 VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Outpatient | PATOKA VALLEY TIER 1 | 9412_PAKOTA VALLEY TIER 1 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Outpatient | ANTHEM TRADITIONAL | 9408_ANTHEM TRADITIONAL VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Outpatient | PATOKA VALLEY TIER 2 | 9415_PAKOTA VALLEY TIER 2 VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | ANTHEM HMO/POS | 9403_ANTHEM HMO POS VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Outpatient | ANTHEM PATHWAY | 9404_ANTHEM PATHWAY VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Outpatient | PATOKA VALLEY TIER 2 | 9413_PAKOTA VALLEY TIER 2 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | PATOKA VALLEY TIER 2 | 9413_PAKOTA VALLEY TIER 2 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | PATOKA VALLEY TIER 1 | 9412_PAKOTA VALLEY TIER 1 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Outpatient | ANTHEM TRADITIONAL | 9408_ANTHEM TRADITIONAL VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Outpatient | ANTHEM PATH | ANTHEM PATH | $499.00 | $187.00 | $140.25 | 2026-04-27 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | ENCORE EXCLUSIVE | 9409_ENCORE EXCUSIVE VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Outpatient | PATOKA VALLEY TIER 2 | 9415_PAKOTA VALLEY TIER 2 VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | ANTHEM SHORT TERM LIMITED DURATION | 9407_ANTHEM SHORT TERM LIMITED DURATION VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | ANTHEM SHORT TERM LIMITED DURATION | 9407_ANTHEM SHORT TERM LIMITED DURATION VEIN 20250101 | $499.00 | $8,871.00 | $5,322.60 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | ANTHEM HEALTHSYNC POS | 9401_ANTHEM HEALTHSYNC POS VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | ANTHEM HEALTHSYNC POS | 9401_ANTHEM HEALTHSYNC POS VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | ANTHEM SHORT TERM LIMITED DURATION | 9407_ANTHEM SHORT TERM LIMITED DURATION VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Outpatient | ANTHEM HEALTHSYNC HMO | 9399_ANTHEM HEALTHSYNC HMO VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | PATOKA VALLEY TIER 2 | 9413_PAKOTA VALLEY TIER 2 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Outpatient | ANTHEM HMO/POS | 9403_ANTHEM HMO POS VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | ANTHEM PATHWAY | 9404_ANTHEM PATHWAY VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | ANTHEM PATHWAY X | 9405_ANTHEM PATHWAY X VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | ANTHEM PPO PREFERRED | 9406_ANTHEM PREFERRED VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | PATOKA VALLEY TIER 1 | 9412_PAKOTA VALLEY TIER 1 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Outpatient | ANTHEM SHORT TERM LIMITED DURATION | 9407_ANTHEM SHORT TERM LIMITED DURATION VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Outpatient | PATOKA VALLEY TIER 1 | 9410_PAKOTA VALLEY TIER 1 VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | PATOKA VALLEY TIER 1 | 9410_PAKOTA VALLEY TIER 1 VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Outpatient | ANTHEM HEALTHSYNC POS | 9401_ANTHEM HEALTHSYNC POS VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | ANTHEM PATHWAY | 9404_ANTHEM PATHWAY VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | PATOKA VALLEY TIER 2 | 9415_PAKOTA VALLEY TIER 2 VEIN 20250101 | $499.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | ANTHEM HEALTHSYNC HMO | 9399_ANTHEM HEALTHSYNC HMO VEIN 20250101 | $499.00 | — | — | 2026-01-01 | 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.