0571T — Insj/rplcmt Icds Ss Eltrd
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). Insj/rplcmt icds ss eltrd (OTHER 0571T) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/0571T?code_type=OTHER
MLA (9th ed.)
“Insj/rplcmt icds ss eltrd (OTHER 0571T) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/0571T?code_type=OTHER. Accessed .
Chicago (notes-bibliography)
“Insj/rplcmt icds ss eltrd (OTHER 0571T) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/0571T?code_type=OTHER.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $18,278–$44,288 (25th–75th percentile) across 595 hospitals · 761 payers.
“Negotiated” is the hospital’s negotiated facility rate for this OTHER 0571T — 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 |
|---|---|---|---|---|---|---|---|
| BELLEVUE MEDICAL CENTER Outpatient | AETNA COMM-ALL OTHER PLANS | AETNA COMM-ALL OTHER PLANS | $78.57 | $1,300.00 | $845.00 | 2026-08-10 | MRF ↗ |
| HACKENSACK UNIVERSITY MEDICAL CENTER OutpatientFacility | HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $104.00 | $66,076.00 | $32,061.58 | 2025-12-31 | MRF ↗ |
| HACKENSACK UNIVERSITY MEDICAL CENTER OutpatientFacility | HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $104.00 | $66,076.00 | $32,061.58 | 2025-12-31 | MRF ↗ |
| UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER OutpatientFacility | Pipe Trades | Ucd Hb Blue Shield Referred | $111.72 | — | — | 2026-04-01 | MRF ↗ |
| UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER OutpatientFacility | Blue Shield | Ucd Hb Blue Shield Calpers | $111.72 | — | — | 2026-04-01 | MRF ↗ |
| UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER OutpatientFacility | Blue Shield | Ucd Hb Blue Shield Ifp | $111.72 | — | — | 2026-04-01 | MRF ↗ |
| UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER OutpatientFacility | Sheet Metal Workers Union(Smw) | Ucd Hb Blue Shield Referred | $111.72 | — | — | 2026-04-01 | MRF ↗ |
| UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER OutpatientFacility | Blue Shield | Ucd Hb Blue Shield Referred | $111.72 | — | — | 2026-04-01 | MRF ↗ |
| UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER OutpatientFacility | Ufcw | Ucd Hb Blue Shield Referred | $111.72 | — | — | 2026-04-01 | MRF ↗ |
| HACKENSACK UNIVERSITY MEDICAL CENTER OutpatientFacility | HORIZON | HMO | $181.00 | $66,076.00 | $32,061.58 | 2025-12-31 | MRF ↗ |
| HACKENSACK UNIVERSITY MEDICAL CENTER OutpatientFacility | HORIZON | HMO | $181.00 | $66,076.00 | $32,061.58 | 2025-12-31 | MRF ↗ |
| HACKENSACK UNIVERSITY MEDICAL CENTER OutpatientFacility | HORIZON | WORKERS COMP | $188.00 | $66,076.00 | $32,061.58 | 2025-12-31 | MRF ↗ |
| HACKENSACK UNIVERSITY MEDICAL CENTER OutpatientFacility | HORIZON | WORKERS COMP | $188.00 | $66,076.00 | $32,061.58 | 2025-12-31 | MRF ↗ |
| MONTEFIORE MEDICAL CENTER Both | Humana | Medicare Midlevels | $189.55 | $3,925.00 | $2,566.95 | 2026-04-01 | MRF ↗ |
| ST MARY MEDICAL CENTER OutpatientFacility | Independence Blue Cross | Traditional | $223.00 | $109,654.00 | $69,301.33 | 2025-01-01 | MRF ↗ |
| MONTEFIORE MEDICAL CENTER Both | Humana | Medicare | $227.46 | $3,925.00 | $2,566.95 | 2026-04-01 | MRF ↗ |
| ST MARY MEDICAL CENTER OutpatientFacility | Independence Blue Cross | HMO_PPO | $233.00 | $109,654.00 | $69,301.33 | 2025-01-01 | MRF ↗ |
| Ascension Sacred Heart Rehabilitation Hospital Both | NETWORK HEALTH PLAN | 1136_NETWORK HEALTH PLAN 20221001 | $278.80 | — | — | 2026-01-01 | MRF ↗ |
| Ascension Columbia St. Mary's Hospital Ozaukee Both | NETWORK HEALTH PLAN | 1136_NETWORK HEALTH PLAN 20221001 | $278.80 | $120,682.00 | $63,961.46 | 2026-01-01 | MRF ↗ |
| ASCENSION COLUMBIA ST MARYS HOSPITAL MILWAUKEE Both | NETWORK HEALTH PLAN | 1136_NETWORK HEALTH PLAN 20221001 | $278.80 | $120,682.00 | $63,961.46 | 2026-01-01 | MRF ↗ |
| PROVIDENCE HOLY CROSS MEDICAL CENTER OutpatientFacility | Blue Shield | Medicare Managed Care Plan | $353.00 | — | — | 2026-04-01 | MRF ↗ |
| PROVIDENCE CEDARS SINAI TARZANA MEDICAL CENTER OutpatientFacility | Blue Shield | Medicare Managed Care Plan | $353.00 | — | — | 2026-04-01 | MRF ↗ |
| PROVIDENCE LITTLE COMPANY OF MARY MED CTR TORRANCE OutpatientFacility | Blue Shield | Medicare Managed Care Plan | $353.00 | — | — | 2026-04-01 | MRF ↗ |
| PROVIDENCE LITTLE CO OF MARY MED CTR SAN PEDRO OutpatientFacility | Blue Shield | Medicare Managed Care Plan | $353.00 | — | — | 2026-04-01 | MRF ↗ |
| PROVIDENCE LITTLE COMPANY OF MARY MED CTR TORRANCE OutpatientFacility | Blue Shield | Medicare Managed Care Plan | $353.00 | — | — | 2026-04-01 | MRF ↗ |
| NORTHBAY MEDICAL CENTER OutpatientFacility | Blue Shield - Asc | All Commercial Plans | $355.95 | — | — | 2026-04-01 | MRF ↗ |
| ASCENSION VIA CHRISTI HOSPITAL MANHATTAN, INC Outpatient | KANCARE UHC | 859_MEDICAID ADVANTAGE KANCARE UNITED HEALTH CARE 20250701 | $375.03 | — | — | 2026-01-01 | MRF ↗ |
| WAMEGO HEALTH CENTER Outpatient | KANCARE UHC | 859_MEDICAID ADVANTAGE KANCARE UNITED HEALTH CARE 20250701 | $375.03 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION VIA CHRISTI HOSPITAL MANHATTAN, INC Outpatient | KANCARE HEALTHY BLUE | 861_MEDICAID ADVANTAGE KANCARE HEALTHY BLUE 20250701 | $390.03 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION VIA CHRISTI HOSPITAL MANHATTAN, INC Outpatient | KANCARE SUNFLOWER | 858_MEDICAID ADVANTAGE KANCARE SUNFLOWER 20250701 | $390.03 | — | — | 2026-01-01 | MRF ↗ |
| WAMEGO HEALTH CENTER Outpatient | KANCARE HEALTHY BLUE | 861_MEDICAID ADVANTAGE KANCARE HEALTHY BLUE 20250701 | $390.03 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION VIA CHRISTI HOSPITAL MANHATTAN, INC Outpatient | KANCARE AETNA | 856_MEDICAID ADVANTAGE KANCARE AETNA 20250701 | $390.03 | — | — | 2026-01-01 | MRF ↗ |
| WAMEGO HEALTH CENTER Outpatient | KANCARE AETNA | 856_MEDICAID ADVANTAGE KANCARE AETNA 20250701 | $390.03 | — | — | 2026-01-01 | MRF ↗ |
| WAMEGO HEALTH CENTER Outpatient | KANCARE SUNFLOWER | 858_MEDICAID ADVANTAGE KANCARE SUNFLOWER 20250701 | $390.03 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | PATOKA VALLEY TIER 1 | 9412_PAKOTA VALLEY TIER 1 20250101 | $522.68 | $46,224.00 | $27,734.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Outpatient | ANTHEM HMO/POS | 9403_ANTHEM HMO POS VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Outpatient | ANTHEM PATHWAY X | 9405_ANTHEM PATHWAY X VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Outpatient | ANTHEM HEALTHSYNC HMO | 9399_ANTHEM HEALTHSYNC HMO VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Outpatient | ANTHEM PPO PREFERRED | 9406_ANTHEM PREFERRED VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Outpatient | ANTHEM HEALTHSYNC HMO | 9399_ANTHEM HEALTHSYNC HMO VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Outpatient | ANTHEM HEALTHSYNC POS | 9402_ANTHEM HEALTHSYNC POS SWIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Outpatient | PATOKA VALLEY TIER 2 | 9415_PAKOTA VALLEY TIER 2 VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | ANTHEM PATHWAY X | 9405_ANTHEM PATHWAY X VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Outpatient | ANTHEM HEALTHSYNC POS | 9401_ANTHEM HEALTHSYNC POS VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Outpatient | ANTHEM PATHWAY | 9404_ANTHEM PATHWAY VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Outpatient | PATOKA VALLEY TIER 2 | 9415_PAKOTA VALLEY TIER 2 VEIN 20250101 | $522.68 | $46,224.00 | $27,734.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Outpatient | ANTHEM TRADITIONAL | 9408_ANTHEM TRADITIONAL VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Outpatient | ANTHEM PPO PREFERRED | 9406_ANTHEM PREFERRED VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Outpatient | PATOKA VALLEY TIER 1 | 9412_PAKOTA VALLEY TIER 1 20250101 | $522.68 | $46,224.00 | $27,734.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Outpatient | ANTHEM PATHWAY | 9404_ANTHEM PATHWAY VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Outpatient | ANTHEM PPO PREFERRED | 9406_ANTHEM PREFERRED VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Outpatient | ANTHEM HMO/POS | 9403_ANTHEM HMO POS VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Outpatient | ANTHEM HEALTHSYNC POS | 9401_ANTHEM HEALTHSYNC POS VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Outpatient | ANTHEM SHORT TERM LIMITED DURATION | 9407_ANTHEM SHORT TERM LIMITED DURATION VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | PATOKA VALLEY TIER 2 | 9413_PAKOTA VALLEY TIER 2 20250101 | $522.68 | $46,224.00 | $27,734.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | ANTHEM TRADITIONAL | 9408_ANTHEM TRADITIONAL VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | ANTHEM TRADITIONAL | 9408_ANTHEM TRADITIONAL VEIN 20250101 | $522.68 | $46,224.00 | $27,734.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Outpatient | ANTHEM HMO/POS | 9403_ANTHEM HMO POS VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | ANTHEM PATHWAY X | 9405_ANTHEM PATHWAY X VEIN 20250101 | $522.68 | $46,224.00 | $27,734.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Outpatient | ANTHEM HEALTHSYNC POS | 9401_ANTHEM HEALTHSYNC POS VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | PATOKA VALLEY TIER 1 | 9410_PAKOTA VALLEY TIER 1 VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | PATOKA VALLEY TIER 1 | 9412_PAKOTA VALLEY TIER 1 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Outpatient | ANTHEM HEALTHSYNC HMO | 9400_ANTHEM HEALTHSYNC HMO SWIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Outpatient | ANTHEM HEALTHSYNC POS | 9401_ANTHEM HEALTHSYNC POS VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Outpatient | ANTHEM PATHWAY X | 9405_ANTHEM PATHWAY X VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | PATOKA VALLEY TIER 1 | 9410_PAKOTA VALLEY TIER 1 VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | ANTHEM TRADITIONAL | 9408_ANTHEM TRADITIONAL VEIN 20250101 | $522.68 | $46,224.00 | $27,734.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Outpatient | PATOKA VALLEY TIER 2 | 9413_PAKOTA VALLEY TIER 2 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | ANTHEM HEALTHSYNC HMO | 9399_ANTHEM HEALTHSYNC HMO VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Outpatient | ANTHEM HEALTHSYNC HMO | 9399_ANTHEM HEALTHSYNC HMO VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | ANTHEM PATHWAY | 9404_ANTHEM PATHWAY VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Outpatient | PATOKA VALLEY TIER 1 | 9410_PAKOTA VALLEY TIER 1 VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Outpatient | PATOKA VALLEY TIER 2 | 9415_PAKOTA VALLEY TIER 2 VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Outpatient | ANTHEM TRADITIONAL | 9408_ANTHEM TRADITIONAL VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Outpatient | PATOKA VALLEY TIER 2 | 9415_PAKOTA VALLEY TIER 2 VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Outpatient | ANTHEM PPO PREFERRED | 9406_ANTHEM PREFERRED VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Outpatient | PATOKA VALLEY TIER 2 | 9413_PAKOTA VALLEY TIER 2 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Outpatient | PATOKA VALLEY TIER 1 | 9412_PAKOTA VALLEY TIER 1 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Outpatient | PATOKA VALLEY TIER 1 | 9412_PAKOTA VALLEY TIER 1 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Outpatient | PATOKA VALLEY TIER 2 | 9413_PAKOTA VALLEY TIER 2 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | ANTHEM HEALTHSYNC POS | 9401_ANTHEM HEALTHSYNC POS VEIN 20250101 | $522.68 | $46,224.00 | $27,734.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Outpatient | ANTHEM HEALTHSYNC POS | 9401_ANTHEM HEALTHSYNC POS VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Outpatient | ENCORE EXCLUSIVE | 9409_ENCORE EXCUSIVE VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Outpatient | ANTHEM PATHWAY | 9404_ANTHEM PATHWAY VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Outpatient | PATOKA VALLEY TIER 1 | 9410_PAKOTA VALLEY TIER 1 VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | ANTHEM PATHWAY | 9404_ANTHEM PATHWAY VEIN 20250101 | $522.68 | $46,224.00 | $27,734.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Outpatient | PATOKA VALLEY TIER 2 | 9415_PAKOTA VALLEY TIER 2 VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | ANTHEM SHORT TERM LIMITED DURATION | 9407_ANTHEM SHORT TERM LIMITED DURATION VEIN 20250101 | $522.68 | $46,224.00 | $27,734.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Outpatient | PATOKA VALLEY TIER 1 | 9410_PAKOTA VALLEY TIER 1 VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Outpatient | PATOKA VALLEY TIER 1 | 9412_PAKOTA VALLEY TIER 1 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | ANTHEM PATHWAY X | 9405_ANTHEM PATHWAY X VEIN 20250101 | $522.68 | $46,224.00 | $27,734.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | ANTHEM HMO/POS | 9403_ANTHEM HMO POS VEIN 20250101 | $522.68 | $46,224.00 | $27,734.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | ANTHEM SHORT TERM LIMITED DURATION | 9407_ANTHEM SHORT TERM LIMITED DURATION VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | ENCORE EXCLUSIVE | 9409_ENCORE EXCUSIVE VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Outpatient | ANTHEM HEALTHSYNC HMO | 9399_ANTHEM HEALTHSYNC HMO VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Outpatient | ANTHEM HEALTHSYNC POS | 9401_ANTHEM HEALTHSYNC POS VEIN 20250101 | $522.68 | $46,224.00 | $27,734.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Outpatient | PATOKA VALLEY TIER 1 | 9410_PAKOTA VALLEY TIER 1 VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Outpatient | PATOKA VALLEY TIER 1 | 9412_PAKOTA VALLEY TIER 1 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Outpatient | ENCORE EXCLUSIVE | 9409_ENCORE EXCUSIVE VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | ENCORE EXCLUSIVE | 9409_ENCORE EXCUSIVE VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Outpatient | ANTHEM PATHWAY X | 9405_ANTHEM PATHWAY X VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | PATOKA VALLEY TIER 2 | 9415_PAKOTA VALLEY TIER 2 VEIN 20250101 | $522.68 | $46,224.00 | $27,734.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | ANTHEM TRADITIONAL | 9408_ANTHEM TRADITIONAL VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Outpatient | PATOKA VALLEY TIER 2 | 9413_PAKOTA VALLEY TIER 2 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Outpatient | ANTHEM TRADITIONAL | 9408_ANTHEM TRADITIONAL VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Outpatient | ANTHEM PATHWAY | 9404_ANTHEM PATHWAY VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Outpatient | PATOKA VALLEY TIER 1 | 9410_PAKOTA VALLEY TIER 1 VEIN 20250101 | $522.68 | $46,224.00 | $27,734.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | ANTHEM HEALTHSYNC POS | 9401_ANTHEM HEALTHSYNC POS VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Outpatient | ANTHEM PATHWAY X | 9405_ANTHEM PATHWAY X VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | PATOKA VALLEY TIER 2 | 9415_PAKOTA VALLEY TIER 2 VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Outpatient | ANTHEM PATHWAY X | 9405_ANTHEM PATHWAY X VEIN 20250101 | $522.68 | $46,224.00 | $27,734.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Outpatient | ANTHEM HEALTHSYNC POS | 9401_ANTHEM HEALTHSYNC POS VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Outpatient | ANTHEM PATHWAY X | 9405_ANTHEM PATHWAY X VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Outpatient | ANTHEM SHORT TERM LIMITED DURATION | 9407_ANTHEM SHORT TERM LIMITED DURATION VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Outpatient | ANTHEM PATHWAY | 9404_ANTHEM PATHWAY VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | ANTHEM PPO PREFERRED | 9406_ANTHEM PREFERRED VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Outpatient | ENCORE EXCLUSIVE | 9409_ENCORE EXCUSIVE VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Outpatient | ANTHEM HEALTHSYNC POS | 9401_ANTHEM HEALTHSYNC POS VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | ANTHEM SHORT TERM LIMITED DURATION | 9407_ANTHEM SHORT TERM LIMITED DURATION VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | PATOKA VALLEY TIER 2 | 9413_PAKOTA VALLEY TIER 2 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Outpatient | PATOKA VALLEY TIER 2 | 9415_PAKOTA VALLEY TIER 2 VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Outpatient | ANTHEM PATHWAY X | 9405_ANTHEM PATHWAY X VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Outpatient | ANTHEM PATHWAY | 9404_ANTHEM PATHWAY VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Outpatient | PATOKA VALLEY TIER 1 | 9410_PAKOTA VALLEY TIER 1 VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | ANTHEM PATHWAY | 9404_ANTHEM PATHWAY VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | ANTHEM SHORT TERM LIMITED DURATION | 9407_ANTHEM SHORT TERM LIMITED DURATION VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Outpatient | PATOKA VALLEY TIER 2 | 9415_PAKOTA VALLEY TIER 2 VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | ANTHEM HEALTHSYNC HMO | 9399_ANTHEM HEALTHSYNC HMO VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | PATOKA VALLEY TIER 2 | 9415_PAKOTA VALLEY TIER 2 VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | ANTHEM PATHWAY | 9404_ANTHEM PATHWAY VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | ANTHEM PPO PREFERRED | 9406_ANTHEM PREFERRED VEIN 20250101 | $522.68 | $46,224.00 | $27,734.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | ANTHEM HEALTHSYNC HMO | 9399_ANTHEM HEALTHSYNC HMO VEIN 20250101 | $522.68 | $46,224.00 | $27,734.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | ANTHEM TRADITIONAL | 9408_ANTHEM TRADITIONAL VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Outpatient | ANTHEM HEALTHSYNC HMO | 9399_ANTHEM HEALTHSYNC HMO VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | PATOKA VALLEY TIER 2 | 9415_PAKOTA VALLEY TIER 2 VEIN 20250101 | $522.68 | $46,224.00 | $27,734.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | ANTHEM HEALTHSYNC HMO | 9399_ANTHEM HEALTHSYNC HMO VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Outpatient | ANTHEM HMO/POS | 9403_ANTHEM HMO POS VEIN 20250101 | $522.68 | $46,224.00 | $27,734.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | ANTHEM HEALTHSYNC POS | 9401_ANTHEM HEALTHSYNC POS VEIN 20250101 | $522.68 | $46,224.00 | $27,734.40 | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Outpatient | ANTHEM PPO PREFERRED | 9406_ANTHEM PREFERRED VEIN 20250101 | $522.68 | $46,224.00 | $27,734.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | PATOKA VALLEY TIER 2 | 9413_PAKOTA VALLEY TIER 2 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Outpatient | ANTHEM TRADITIONAL | 9408_ANTHEM TRADITIONAL VEIN 20250101 | $522.68 | $46,224.00 | $27,734.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | ANTHEM PPO PREFERRED | 9406_ANTHEM PREFERRED VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | ANTHEM PPO PREFERRED | 9406_ANTHEM PREFERRED VEIN 20250101 | $522.68 | $46,224.00 | $27,734.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Outpatient | PATOKA VALLEY TIER 1 | 9410_PAKOTA VALLEY TIER 1 VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | ANTHEM PATHWAY X | 9405_ANTHEM PATHWAY X VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | ENCORE EXCLUSIVE | 9409_ENCORE EXCUSIVE VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | ANTHEM TRADITIONAL | 9408_ANTHEM TRADITIONAL VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Outpatient | ANTHEM TRADITIONAL | 9408_ANTHEM TRADITIONAL VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | PATOKA VALLEY TIER 1 | 9410_PAKOTA VALLEY TIER 1 VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | ANTHEM SHORT TERM LIMITED DURATION | 9407_ANTHEM SHORT TERM LIMITED DURATION VEIN 20250101 | $522.68 | $46,224.00 | $27,734.40 | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Outpatient | ANTHEM PATHWAY | 9404_ANTHEM PATHWAY VEIN 20250101 | $522.68 | $46,224.00 | $27,734.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Outpatient | ANTHEM PATHWAY | 9404_ANTHEM PATHWAY VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Outpatient | ANTHEM TRADITIONAL | 9408_ANTHEM TRADITIONAL VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | PATOKA VALLEY TIER 2 | 9415_PAKOTA VALLEY TIER 2 VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | ENCORE EXCLUSIVE | 9409_ENCORE EXCUSIVE VEIN 20250101 | $522.68 | $46,224.00 | $27,734.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Outpatient | ANTHEM PPO PREFERRED | 9406_ANTHEM PREFERRED VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Outpatient | ANTHEM HMO/POS | 9403_ANTHEM HMO POS VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Outpatient | ANTHEM SHORT TERM LIMITED DURATION | 9407_ANTHEM SHORT TERM LIMITED DURATION VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | ANTHEM HMO/POS | 9403_ANTHEM HMO POS VEIN 20250101 | $522.68 | $46,224.00 | $27,734.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Outpatient | ANTHEM SHORT TERM LIMITED DURATION | 9407_ANTHEM SHORT TERM LIMITED DURATION VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Outpatient | ENCORE EXCLUSIVE | 9409_ENCORE EXCUSIVE VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | ANTHEM HMO/POS | 9403_ANTHEM HMO POS VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | ANTHEM HEALTHSYNC POS | 9401_ANTHEM HEALTHSYNC POS VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | ANTHEM PPO PREFERRED | 9406_ANTHEM PREFERRED VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Outpatient | ANTHEM HEALTHSYNC HMO | 9399_ANTHEM HEALTHSYNC HMO VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Outpatient | ANTHEM HEALTHSYNC HMO | 9399_ANTHEM HEALTHSYNC HMO VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Outpatient | ANTHEM TRADITIONAL | 9408_ANTHEM TRADITIONAL VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Outpatient | ANTHEM TRADITIONAL | 9408_ANTHEM TRADITIONAL VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | PATOKA VALLEY TIER 2 | 9415_PAKOTA VALLEY TIER 2 VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | ANTHEM PATHWAY X | 9405_ANTHEM PATHWAY X VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Outpatient | ENCORE EXCLUSIVE | 9409_ENCORE EXCUSIVE VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | PATOKA VALLEY TIER 1 | 9410_PAKOTA VALLEY TIER 1 VEIN 20250101 | $522.68 | $46,224.00 | $27,734.40 | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Outpatient | ENCORE EXCLUSIVE | 9409_ENCORE EXCUSIVE VEIN 20250101 | $522.68 | $46,224.00 | $27,734.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | ANTHEM HEALTHSYNC POS | 9401_ANTHEM HEALTHSYNC POS VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | PATOKA VALLEY TIER 1 | 9410_PAKOTA VALLEY TIER 1 VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | PATOKA VALLEY TIER 2 | 9413_PAKOTA VALLEY TIER 2 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Outpatient | PATOKA VALLEY TIER 2 | 9413_PAKOTA VALLEY TIER 2 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | ANTHEM HMO/POS | 9403_ANTHEM HMO POS VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | PATOKA VALLEY TIER 1 | 9412_PAKOTA VALLEY TIER 1 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | PATOKA VALLEY TIER 1 | 9412_PAKOTA VALLEY TIER 1 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | ANTHEM PATHWAY X | 9405_ANTHEM PATHWAY X VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | PATOKA VALLEY TIER 1 | 9412_PAKOTA VALLEY TIER 1 20250101 | $522.68 | $46,224.00 | $27,734.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | PATOKA VALLEY TIER 1 | 9412_PAKOTA VALLEY TIER 1 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Outpatient | ANTHEM SHORT TERM LIMITED DURATION | 9407_ANTHEM SHORT TERM LIMITED DURATION VEIN 20250101 | $522.68 | $46,224.00 | $27,734.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | ANTHEM HEALTHSYNC HMO | 9399_ANTHEM HEALTHSYNC HMO VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | ENCORE EXCLUSIVE | 9409_ENCORE EXCUSIVE VEIN 20250101 | $522.68 | $46,224.00 | $27,734.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Outpatient | ANTHEM SHORT TERM LIMITED DURATION | 9407_ANTHEM SHORT TERM LIMITED DURATION VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Outpatient | ANTHEM HEALTHSYNC HMO | 9399_ANTHEM HEALTHSYNC HMO VEIN 20250101 | $522.68 | $46,224.00 | $27,734.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | ANTHEM PATHWAY | 9404_ANTHEM PATHWAY VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | PATOKA VALLEY TIER 2 | 9413_PAKOTA VALLEY TIER 2 20250101 | $522.68 | $46,224.00 | $27,734.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Outpatient | ANTHEM HMO/POS | 9403_ANTHEM HMO POS VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Outpatient | ANTHEM SHORT TERM LIMITED DURATION | 9407_ANTHEM SHORT TERM LIMITED DURATION VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | PATOKA VALLEY TIER 2 | 9413_PAKOTA VALLEY TIER 2 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | ANTHEM HMO/POS | 9403_ANTHEM HMO POS VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Outpatient | ENCORE EXCLUSIVE | 9409_ENCORE EXCUSIVE VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | ANTHEM HEALTHSYNC HMO | 9399_ANTHEM HEALTHSYNC HMO VEIN 20250101 | $522.68 | $46,224.00 | $27,734.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Outpatient | ANTHEM PPO PREFERRED | 9406_ANTHEM PREFERRED VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | PATOKA VALLEY TIER 1 | 9410_PAKOTA VALLEY TIER 1 VEIN 20250101 | $522.68 | $46,224.00 | $27,734.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | ANTHEM HMO/POS | 9403_ANTHEM HMO POS VEIN 20250101 | $522.68 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | ANTHEM HEALTHSYNC POS | 9401_ANTHEM HEALTHSYNC POS VEIN 20250101 | $522.68 | — | — | 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.