0919 — Inj, Zymfentra, 10 Mg
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). Inj, zymfentra, 10 mg (OTHER 0919) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/0919?code_type=OTHER
MLA (9th ed.)
“Inj, zymfentra, 10 mg (OTHER 0919) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/0919?code_type=OTHER. Accessed .
Chicago (notes-bibliography)
“Inj, zymfentra, 10 mg (OTHER 0919) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/0919?code_type=OTHER.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $100–$136 (25th–75th percentile) across 9 hospitals · 32 payers.
“Negotiated” is the hospital’s negotiated facility rate for this OTHER 0919 — 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 |
|---|---|---|---|---|---|---|---|
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Alliance | Managed Medicaid | $27.38 | $117.00 | $70.20 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | United Healthcare | Managed Medicaid | $27.79 | $117.00 | $70.20 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Healthy Blue North Carolina | Managed Medicaid | $28.07 | $117.00 | $70.20 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Vaya Health | Managed Medicaid | $28.20 | $117.00 | $70.20 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Amerihealth Caritas North Carolina | Managed Medicaid | $28.48 | $117.00 | $70.20 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Alliance | Managed Medicaid | $31.82 | $136.00 | $81.60 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | United Healthcare | Managed Medicaid | $32.30 | $136.00 | $81.60 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Healthy Blue North Carolina | Managed Medicaid | $32.63 | $136.00 | $81.60 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Vaya Health | Managed Medicaid | $32.78 | $136.00 | $81.60 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Amerihealth Caritas North Carolina | Managed Medicaid | $33.10 | $136.00 | $81.60 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Medcost | Ppo | $64.35 | $117.00 | $70.20 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Medcost | Ultra | $64.35 | $117.00 | $70.20 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Medcost | — | $64.35 | $117.00 | $70.20 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Medcost | — | $74.80 | $136.00 | $81.60 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Medcost | Ppo | $74.80 | $136.00 | $81.60 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Medcost | Ultra | $74.80 | $136.00 | $81.60 | 2026-05-27 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Outpatient | CDPHP MEDICARE [1320] | CDPHP MEDICARE [132001] | $99.76 | — | — | 2026-04-01 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Outpatient | EXCELLUS BLUE CROSS BLUE SHIELD [2201], OUT AREA BLUE CROSS BLUE SHIELD, UNIVERA | EXCELLUS [220101], EXCELLUS SIMPLY BLUE [220106], EXCELLUS BLUE CHOICE [220107] | $99.76 | — | — | 2026-04-01 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Outpatient | EXCELLUS BLUE CROSS BLUE SHIELD [2201], OUT AREA BLUE CROSS BLUE SHIELD, UNIVERA | EXCELLUS METAL TIERS [220102] | $99.76 | — | — | 2026-04-01 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Outpatient | HIGHMARK BLUE CROSS BLUE SHIELD MEDICARE [1301] | HIGHMARK BCBS MEDICARE [130101] | $99.76 | — | — | 2026-04-01 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Outpatient | EXCELLUS BLUE CROSS BLUE SHIELD [2201] | EXCELLUS HIGH PERFORMANCE [220103] | $99.76 | — | — | 2026-04-01 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Outpatient | FIDELIS MEDICARE [1311] | FIDELIS MEDICARE [131101] | $99.76 | — | — | 2026-04-01 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Outpatient | MVP MEDICARE [1307] | MVP MEDICARE [130701] | $99.76 | — | — | 2026-04-01 | MRF ↗ |
| HIGHLAND HOSPITAL Outpatient | AETNA MEDICARE [1300] | AETNA MEDICARE [130001] | $99.76 | — | — | 2026-04-01 | MRF ↗ |
| HIGHLAND HOSPITAL Outpatient | MVP [2900] | MVP HEALTH CARE [290001], MVP PREMIER GROUP [290003] | $99.76 | — | — | 2026-04-01 | MRF ↗ |
| HIGHLAND HOSPITAL Outpatient | MVP [2900] | MVP PREMIER INDIVIDUAL [290002] | $99.76 | — | — | 2026-04-01 | MRF ↗ |
| HIGHLAND HOSPITAL Outpatient | MVP [2900] | MVP COMMERCIAL PPO FULLY INSURED [290006] | $99.76 | — | — | 2026-04-01 | MRF ↗ |
| HIGHLAND HOSPITAL Outpatient | CIGNA [5144] | CIGNA HEALTHCARE (POB 182223) [514405] | $99.76 | — | — | 2026-04-01 | MRF ↗ |
| HIGHLAND HOSPITAL Outpatient | MEDICARE BLUE CHOICE [1306] | MEDICARE BLUE CHOICE [130601] | $99.76 | — | — | 2026-04-01 | MRF ↗ |
| HIGHLAND HOSPITAL Outpatient | UNITED HEALTHCARE MEDICARE [1309] | UNITED HEALTHCARE MEDICARE [130901] | $99.76 | — | — | 2026-04-01 | MRF ↗ |
| HIGHLAND HOSPITAL Outpatient | HUMANA MEDICARE [1312] | HUMANA MEDICARE [131201] | $99.76 | — | — | 2026-04-01 | MRF ↗ |
| HIGHLAND HOSPITAL Outpatient | MARTINS POINT [1205] | US FAMILY PLAN AT MARTIN'S POINT [120501] | $99.76 | — | — | 2026-04-01 | MRF ↗ |
| HIGHLAND HOSPITAL Outpatient | CDPHP MEDICARE [1320] | CDPHP MEDICARE [132001] | $99.76 | — | — | 2026-04-01 | MRF ↗ |
| HIGHLAND HOSPITAL Outpatient | EXCELLUS BLUE CROSS BLUE SHIELD [2201], OUT AREA BLUE CROSS BLUE SHIELD, UNIVERA | EXCELLUS [220101], EXCELLUS SIMPLY BLUE [220106], EXCELLUS BLUE CHOICE [220107] | $99.76 | — | — | 2026-04-01 | MRF ↗ |
| HIGHLAND HOSPITAL Outpatient | EXCELLUS BLUE CROSS BLUE SHIELD [2201], OUT AREA BLUE CROSS BLUE SHIELD, UNIVERA | EXCELLUS METAL TIERS [220102] | $99.76 | — | — | 2026-04-01 | MRF ↗ |
| HIGHLAND HOSPITAL Outpatient | HIGHMARK BLUE CROSS BLUE SHIELD MEDICARE [1301] | HIGHMARK BCBS MEDICARE [130101] | $99.76 | — | — | 2026-04-01 | MRF ↗ |
| HIGHLAND HOSPITAL Outpatient | EXCELLUS BLUE CROSS BLUE SHIELD [2201] | EXCELLUS HIGH PERFORMANCE [220103] | $99.76 | — | — | 2026-04-01 | MRF ↗ |
| HIGHLAND HOSPITAL Outpatient | FIDELIS MEDICARE [1311] | FIDELIS MEDICARE [131101] | $99.76 | — | — | 2026-04-01 | MRF ↗ |
| HIGHLAND HOSPITAL Outpatient | MVP MEDICARE [1307] | MVP MEDICARE [130701] | $99.76 | — | — | 2026-04-01 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Outpatient | CIGNA [5144] | CIGNA HEALTHCARE (POB 182223) [514405] | $99.76 | — | — | 2026-04-01 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Outpatient | MVP [2900] | MVP HEALTH CARE [290001], MVP PREMIER GROUP [290003] | $99.76 | — | — | 2026-04-01 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Outpatient | MVP [2900] | MVP PREMIER INDIVIDUAL [290002] | $99.76 | — | — | 2026-04-01 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Outpatient | MVP [2900] | MVP COMMERCIAL PPO FULLY INSURED [290006] | $99.76 | — | — | 2026-04-01 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Outpatient | AETNA MEDICARE [1300] | AETNA MEDICARE [130001] | $99.76 | — | — | 2026-04-01 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Outpatient | MEDICARE BLUE CHOICE [1306] | MEDICARE BLUE CHOICE [130601] | $99.76 | — | — | 2026-04-01 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Outpatient | HUMANA MEDICARE [1312] | HUMANA MEDICARE [131201] | $99.76 | — | — | 2026-04-01 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Outpatient | MARTINS POINT [1205] | US FAMILY PLAN AT MARTIN'S POINT [120501] | $99.76 | — | — | 2026-04-01 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Outpatient | UNITED HEALTHCARE MEDICARE [1309] | UNITED HEALTHCARE MEDICARE [130901] | $99.76 | — | — | 2026-04-01 | MRF ↗ |
| CHARLES A CANNON JR MEMORIAL HOSPITAL Outpatient | Tricare | Select | $102.23 | $293.00 | $175.80 | 2026-05-09 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Cigna | Medicare Advantage | $117.00 | $117.00 | $70.20 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Surest | — | $117.00 | $117.00 | $70.20 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Wellcare | Medicare Advantage | $117.00 | $117.00 | $70.20 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | United Healthcare | — | $117.00 | $117.00 | $70.20 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | United Healthcare | Exchange | $117.00 | $117.00 | $70.20 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | United Healthcare | Medicare Advantage | $117.00 | $117.00 | $70.20 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Cigna | Choice | $117.00 | $117.00 | $70.20 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Cigna | Behavioral Health | $117.00 | $117.00 | $70.20 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Humana | Medicare Advantage State Health Plan | $117.00 | $117.00 | $70.20 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Humana | Medicare Advantage Gold Plus | $117.00 | $117.00 | $70.20 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Tricare | Select | $117.00 | $117.00 | $70.20 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Umr | — | $117.00 | $117.00 | $70.20 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Aetna | State Health Plan | $117.00 | $117.00 | $70.20 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Aetna | Medicare Advantage | $117.00 | $117.00 | $70.20 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Aetna | Choice Pos | $117.00 | $117.00 | $70.20 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Bcbs | Blue Value | $117.00 | $117.00 | $70.20 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Bcbs | Blue Home | $117.00 | $117.00 | $70.20 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Bcbs | Option Ppo | $117.00 | $117.00 | $70.20 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Bcbs | Medicare Advantage | $117.00 | $117.00 | $70.20 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Partners | Managed Medicaid | $117.00 | $117.00 | $70.20 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Trillium | Managed Medicaid | $117.00 | $117.00 | $70.20 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Alignment | Preferred Plus Hmo | $117.00 | $117.00 | $70.20 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Nalc Health Benefit Plan | Hmo/Ppo | $117.00 | $117.00 | $70.20 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | First Medicare Direct | Medicare Advantage | $117.00 | $117.00 | $70.20 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Bcbs | Blue Value | $136.00 | $136.00 | $81.60 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | United Healthcare | — | $136.00 | $136.00 | $81.60 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Cigna | Choice | $136.00 | $136.00 | $81.60 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Cigna | Medicare Advantage | $136.00 | $136.00 | $81.60 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | United Healthcare | Medicare Advantage | $136.00 | $136.00 | $81.60 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | United Healthcare | Exchange | $136.00 | $136.00 | $81.60 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Umr | — | $136.00 | $136.00 | $81.60 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Tricare | Select | $136.00 | $136.00 | $81.60 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Humana | Medicare Advantage Gold Plus | $136.00 | $136.00 | $81.60 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Aetna | Choice Pos | $136.00 | $136.00 | $81.60 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Alignment | Preferred Plus Hmo | $136.00 | $136.00 | $81.60 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Aetna | State Health Plan | $136.00 | $136.00 | $81.60 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Partners | Managed Medicaid | $136.00 | $136.00 | $81.60 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Trillium | Managed Medicaid | $136.00 | $136.00 | $81.60 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Aetna | Medicare Advantage | $136.00 | $136.00 | $81.60 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Humana | Medicare Advantage State Health Plan | $136.00 | $136.00 | $81.60 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Cigna | Behavioral Health | $136.00 | $136.00 | $81.60 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Surest | — | $136.00 | $136.00 | $81.60 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Nalc Health Benefit Plan | Hmo/Ppo | $136.00 | $136.00 | $81.60 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Bcbs | Medicare Advantage | $136.00 | $136.00 | $81.60 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | First Medicare Direct | Medicare Advantage | $136.00 | $136.00 | $81.60 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Bcbs | Option Ppo | $136.00 | $136.00 | $81.60 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Bcbs | Blue Home | $136.00 | $136.00 | $81.60 | 2026-05-27 | MRF ↗ |
| PARDEE HOSPITAL HENDERSON COUNTY Outpatient | Wellcare | Medicare Advantage | $136.00 | $136.00 | $81.60 | 2026-05-27 | MRF ↗ |
| APPALACHIAN REGIONAL BEHAVIORAL HEALTHCARE Outpatient | Tricare | Hmo | $138.63 | $293.00 | $175.80 | 2026-05-06 | MRF ↗ |
| UNC HOSPITALS Outpatient | Tricare | Hmo | $156.74 | $422.00 | $253.20 | 2026-05-06 | MRF ↗ |
| WATAUGA MEDICAL CENTER Outpatient | Tricare | Select | $161.01 | $293.00 | $175.80 | 2026-05-27 | 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 | United Healthcare | Umr-United Med Resources | $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 | United Healthcare | Uhc Other/Supplemental | $707.00 | — | — | 2026-05-22 | 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 | Surest | $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 | Medica | $707.00 | — | — | 2026-05-22 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | Healthscope | $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 | Geha | Geha | $707.00 | — | — | 2026-05-22 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | Uhc Charter/Navigate | $707.00 | — | — | 2026-05-22 | MRF ↗ |
| COLUMBIA MEMORIAL HOSPITAL Outpatient | Blue Cross | Blue Access Small Group | $2,449.00 | — | — | 2026-05-08 | MRF ↗ |
| COLUMBIA MEMORIAL HOSPITAL Outpatient | Blue Cross | Indemnity Commercial | $2,881.00 | — | — | 2026-05-08 | MRF ↗ |
| COLUMBIA MEMORIAL HOSPITAL Outpatient | Blue Cross | Ppo | $2,881.00 | — | — | 2026-05-08 | MRF ↗ |
| COLUMBIA MEMORIAL HOSPITAL Outpatient | Blue Cross | Hmo/Epo | $2,881.00 | — | — | 2026-05-08 | MRF ↗ |