0369 — Hc Plasma Rich Platelets
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). HC Plasma Rich Platelets (OTHER 0369) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/0369?code_type=OTHER
MLA (9th ed.)
“HC Plasma Rich Platelets (OTHER 0369) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/0369?code_type=OTHER. Accessed .
Chicago (notes-bibliography)
“HC Plasma Rich Platelets (OTHER 0369) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/0369?code_type=OTHER.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $70–$1,734 (25th–75th percentile) across 16 hospitals · 30 payers.
“Negotiated” is the hospital’s negotiated facility rate for this OTHER 0369 — 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 |
|---|---|---|---|---|---|---|---|
| MEASE COUNTRYSIDE HOSPITAL Outpatient | Aetna | Commercial Other | — | — | — | 2026-05-22 | MRF ↗ |
| MEASE COUNTRYSIDE HOSPITAL Outpatient | United Healthcare | Commercial Ppo | — | — | — | 2026-05-22 | MRF ↗ |
| MEASE COUNTRYSIDE HOSPITAL Outpatient | Cigna | Commercial Ppo | — | — | — | 2026-05-22 | MRF ↗ |
| MEASE COUNTRYSIDE HOSPITAL Outpatient | Cigna | Commercial Hmo | — | — | — | 2026-05-22 | MRF ↗ |
| MEASE COUNTRYSIDE HOSPITAL Outpatient | Aetna | Commercial Hmo | — | — | — | 2026-05-22 | MRF ↗ |
| BARTOW REGIONAL MEDICAL CENTER Outpatient | United Healthcare | Commercial Ppo | — | — | — | 2026-05-13 | MRF ↗ |
| BARTOW REGIONAL MEDICAL CENTER Outpatient | Aetna | Commercial Hmo | — | — | — | 2026-05-13 | MRF ↗ |
| BARTOW REGIONAL MEDICAL CENTER Outpatient | Cigna | Commercial Hmo | — | — | — | 2026-05-13 | MRF ↗ |
| BARTOW REGIONAL MEDICAL CENTER Outpatient | Aetna | Commercial Other | — | — | — | 2026-05-13 | MRF ↗ |
| MEASE DUNEDIN HOSPITAL Outpatient | United Healthcare | Commercial Ppo | — | — | — | 2026-05-15 | MRF ↗ |
| MEASE DUNEDIN HOSPITAL Outpatient | Cigna | Commercial Hmo | — | — | — | 2026-05-15 | MRF ↗ |
| MEASE DUNEDIN HOSPITAL Outpatient | Cigna | Commercial Ppo | — | — | — | 2026-05-15 | MRF ↗ |
| MEASE DUNEDIN HOSPITAL Outpatient | Aetna | Commercial Hmo | — | — | — | 2026-05-15 | MRF ↗ |
| MEASE DUNEDIN HOSPITAL Outpatient | Aetna | Commercial Other | — | — | — | 2026-05-15 | MRF ↗ |
| BARTOW REGIONAL MEDICAL CENTER Outpatient | Cigna | Commercial Ppo | — | — | — | 2026-05-13 | MRF ↗ |
| MEASE COUNTRYSIDE HOSPITAL Outpatient | United Healthcare | Commercial Ppo | — | — | — | 2026-05-18 | MRF ↗ |
| MEASE COUNTRYSIDE HOSPITAL Outpatient | Cigna | Commercial Ppo | — | — | — | 2026-05-18 | MRF ↗ |
| MEASE COUNTRYSIDE HOSPITAL Outpatient | Cigna | Commercial Hmo | — | — | — | 2026-05-18 | MRF ↗ |
| MEASE COUNTRYSIDE HOSPITAL Outpatient | Aetna | Commercial Other | — | — | — | 2026-05-18 | MRF ↗ |
| MEASE COUNTRYSIDE HOSPITAL Outpatient | Aetna | Commercial Hmo | — | — | — | 2026-05-18 | MRF ↗ |
| BARTOW REGIONAL MEDICAL CENTER Outpatient | Aetna | Commercial Hmo | — | — | — | 2026-05-22 | MRF ↗ |
| BARTOW REGIONAL MEDICAL CENTER Outpatient | Aetna | Commercial Other | — | — | — | 2026-05-22 | MRF ↗ |
| BARTOW REGIONAL MEDICAL CENTER Outpatient | Cigna | Commercial Ppo | — | — | — | 2026-05-22 | MRF ↗ |
| BARTOW REGIONAL MEDICAL CENTER Outpatient | Cigna | Commercial Hmo | — | — | — | 2026-05-22 | MRF ↗ |
| BARTOW REGIONAL MEDICAL CENTER Outpatient | United Healthcare | Commercial Ppo | — | — | — | 2026-05-22 | MRF ↗ |
| WAKEMED, CARY HOSPITAL Outpatient | First Health | Coventry Carelink | — | — | — | 2026-05-06 | MRF ↗ |
| WAKEMED, CARY HOSPITAL Outpatient | Bcbs | Commercial | — | — | — | 2026-05-06 | MRF ↗ |
| WAKEMED, RALEIGH CAMPUS Outpatient | Bcbs | Commercial | — | — | — | 2026-05-09 | MRF ↗ |
| WAKEMED, RALEIGH CAMPUS Outpatient | First Health | Coventry Carelink | — | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | Selectcolorado | — | — | — | 2026-05-17 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | Geha | Geha | — | — | — | 2026-05-17 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | Geha | Geha Mcr Supplemental | — | — | — | 2026-05-17 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | Medica | — | — | — | 2026-05-17 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | All Savers Alternative Funding | — | — | — | 2026-05-17 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | Uhc Other/Supplemental | — | — | — | 2026-05-17 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | Healthscope | — | — | — | 2026-05-17 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | Umr-United Med Resources | — | — | — | 2026-05-17 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | Golden Rule Ins | — | — | — | 2026-05-17 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | United Healthcare | — | — | — | 2026-05-17 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | Uhc Charter/Navigate | — | — | — | 2026-05-17 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | Surest | — | — | — | 2026-05-17 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | Uhc Exchange Plan | — | — | — | 2026-05-17 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Immergrun | Commercial | — | — | — | 2026-05-09 | MRF ↗ |
| GILLETTE CHILDRENS SPECIALTY HOSPITAL Outpatient | Medica | Commercial | — | — | — | 2026-05-09 | MRF ↗ |
| GOLETA VALLEY COTTAGE HOSPITAL Outpatient | Blue Shield | Trio Hmo | — | — | — | 2026-05-27 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Uhc | Commercial | — | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Uhc | Commercial | — | — | — | 2026-05-23 | MRF ↗ |
| COLUMBIA MEMORIAL HOSPITAL Outpatient | Emblem Health | Commercial | — | — | — | 2026-05-08 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Arkansas Total Care | Medicaid | $320.00 | — | — | 2026-05-09 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Caresource | Medicaid | $320.00 | — | — | 2026-05-09 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Carolina Complete Health | Managed Medicaid | $669.19 | $3,326.00 | $1,995.60 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Wellcare | Managed Medicaid | $669.19 | $3,326.00 | $1,995.60 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Alliance | Managed Medicaid | $669.19 | $3,326.00 | $1,995.60 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | United Healthcare | Managed Medicaid | $669.19 | $3,326.00 | $1,995.60 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Healthy Blue North Carolina | Managed Medicaid | $669.19 | $3,326.00 | $1,995.60 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Amerihealth Caritas North Carolina | Managed Medicaid | $669.19 | $3,326.00 | $1,995.60 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Trillium | Managed Medicaid | $685.49 | $3,326.00 | $1,995.60 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Vaya Health | Managed Medicaid | $689.15 | $3,326.00 | $1,995.60 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Partners | Managed Medicaid | $689.15 | $3,326.00 | $1,995.60 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | United Healthcare | Managed Medicaid | $702.59 | $3,492.00 | $2,095.20 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Healthy Blue North Carolina | Managed Medicaid | $702.59 | $3,492.00 | $2,095.20 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Amerihealth Caritas North Carolina | Managed Medicaid | $702.59 | $3,492.00 | $2,095.20 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Wellcare | Managed Medicaid | $702.59 | $3,492.00 | $2,095.20 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Alliance | Managed Medicaid | $702.59 | $3,492.00 | $2,095.20 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Carolina Complete Health | Managed Medicaid | $702.59 | $3,492.00 | $2,095.20 | 2026-05-06 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | United Healthcare | $707.00 | — | — | 2026-05-22 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | All Savers Alternative Funding | $707.00 | — | — | 2026-05-22 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | Geha | Geha | $707.00 | — | — | 2026-05-22 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | Golden Rule Ins | $707.00 | — | — | 2026-05-22 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | Geha | Geha Mcr Supplemental | $707.00 | — | — | 2026-05-22 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | Umr-United Med Resources | $707.00 | — | — | 2026-05-22 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | Uhc Other/Supplemental | $707.00 | — | — | 2026-05-22 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | Uhc Exchange Plan | $707.00 | — | — | 2026-05-22 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | Uhc Charter/Navigate | $707.00 | — | — | 2026-05-22 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | Surest | $707.00 | — | — | 2026-05-22 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | Medica | $707.00 | — | — | 2026-05-22 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | Healthscope | $707.00 | — | — | 2026-05-22 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Trillium | Managed Medicaid | $719.70 | $3,492.00 | $2,095.20 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Partners | Managed Medicaid | $723.54 | $3,492.00 | $2,095.20 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Vaya Health | Managed Medicaid | $723.54 | $3,492.00 | $2,095.20 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Bcbs | Option Ppo | $1,040.04 | $3,326.00 | $1,995.60 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Bcbs | Blue Home | $1,040.04 | $3,326.00 | $1,995.60 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Bcbs | Blue Value | $1,040.04 | $3,326.00 | $1,995.60 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Bcbs | Medicare Advantage | $1,067.65 | $3,326.00 | $1,995.60 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Bcbs | Blue Value | $1,091.95 | $3,492.00 | $2,095.20 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Bcbs | Blue Home | $1,091.95 | $3,492.00 | $2,095.20 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Bcbs | Option Ppo | $1,091.95 | $3,492.00 | $2,095.20 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Bcbs | Medicare Advantage | $1,120.93 | $3,492.00 | $2,095.20 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | United Healthcare | Exchange | $1,227.29 | $3,326.00 | $1,995.60 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | United Healthcare | Exchange | $1,288.55 | $3,492.00 | $2,095.20 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Contigo | — | $1,330.40 | $3,326.00 | $1,995.60 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Umr | — | $1,380.29 | $3,326.00 | $1,995.60 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | United Healthcare | — | $1,380.29 | $3,326.00 | $1,995.60 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Surest | — | $1,380.29 | $3,326.00 | $1,995.60 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Contigo | — | $1,396.80 | $3,492.00 | $2,095.20 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Surest | — | $1,449.18 | $3,492.00 | $2,095.20 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Umr | — | $1,449.18 | $3,492.00 | $2,095.20 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | United Healthcare | — | $1,449.18 | $3,492.00 | $2,095.20 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Nalc Health Benefit Plan | Hmo/Ppo | $1,506.68 | $3,326.00 | $1,995.60 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Cigna | Choice | $1,506.68 | $3,326.00 | $1,995.60 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Aetna | State Health Plan | $1,529.96 | $3,326.00 | $1,995.60 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Nalc Health Benefit Plan | Hmo/Ppo | $1,581.88 | $3,492.00 | $2,095.20 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Cigna | Choice | $1,581.88 | $3,492.00 | $2,095.20 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Aetna | State Health Plan | $1,606.32 | $3,492.00 | $2,095.20 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Aetna | Choice Pos | $1,862.56 | $3,326.00 | $1,995.60 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Aetna | Choice Pos | $1,955.52 | $3,492.00 | $2,095.20 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Medcost | Ultra | $2,161.90 | $3,326.00 | $1,995.60 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Medcost | Ultra | $2,269.80 | $3,492.00 | $2,095.20 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Medcost | — | $2,627.54 | $3,326.00 | $1,995.60 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Medcost | Ppo | $2,727.32 | $3,326.00 | $1,995.60 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Medcost | — | $2,758.68 | $3,492.00 | $2,095.20 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Medcost | Ppo | $2,863.44 | $3,492.00 | $2,095.20 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Alignment | Medicare Advantage | $3,326.00 | $3,326.00 | $1,995.60 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Cigna | Behavioral Health | $3,326.00 | $3,326.00 | $1,995.60 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Cigna | Medicare Advantage | $3,326.00 | $3,326.00 | $1,995.60 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Aetna | Medicare Advantage | $3,326.00 | $3,326.00 | $1,995.60 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Optum Health | Behavioral Health | $3,326.00 | $3,326.00 | $1,995.60 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Humana | Medicare Advantage State Health Plan | $3,326.00 | $3,326.00 | $1,995.60 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Liberty | Medicare Advantage | $3,326.00 | $3,326.00 | $1,995.60 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Humana | Medicare Advantage Ppo | $3,326.00 | $3,326.00 | $1,995.60 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Tricare | Select | $3,326.00 | $3,326.00 | $1,995.60 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | First Health Network | — | $3,326.00 | $3,326.00 | $1,995.60 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | United Healthcare | Hmo | $3,326.00 | $3,326.00 | $1,995.60 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Wellcare | Medicare Advantage | $3,326.00 | $3,326.00 | $1,995.60 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | United Healthcare | Hmo | $3,492.00 | $3,492.00 | $2,095.20 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Cigna | Behavioral Health | $3,492.00 | $3,492.00 | $2,095.20 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Alignment | Medicare Advantage | $3,492.00 | $3,492.00 | $2,095.20 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Cigna | Medicare Advantage | $3,492.00 | $3,492.00 | $2,095.20 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | First Health Network | — | $3,492.00 | $3,492.00 | $2,095.20 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Wellcare | Medicare Advantage | $3,492.00 | $3,492.00 | $2,095.20 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Aetna | Medicare Advantage | $3,492.00 | $3,492.00 | $2,095.20 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Optum Health | Behavioral Health | $3,492.00 | $3,492.00 | $2,095.20 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Tricare | Select | $3,492.00 | $3,492.00 | $2,095.20 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Liberty | Medicare Advantage | $3,492.00 | $3,492.00 | $2,095.20 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Humana | Medicare Advantage Ppo | $3,492.00 | $3,492.00 | $2,095.20 | 2026-05-06 | MRF ↗ |
| UNC HEALTH NASH Outpatient | Humana | Medicare Advantage State Health Plan | $3,492.00 | $3,492.00 | $2,095.20 | 2026-05-06 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | Kaiser Perm Hmo | Kp Select Hmo | $4,755.00 | — | — | 2026-05-18 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | Kaiser Perm Hmo | Kp Select Hmo | $4,755.00 | — | — | 2026-05-14 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | Kaiser Perm Hmo | Kp Select Hmo | $4,755.00 | — | — | 2026-05-22 | MRF ↗ |