101205 — Drape Surg Convertors Ancillary Half Sheet 44inx58in Fan Fold Nonwoven Lf Sms Strl Disp
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). DRAPE SURG CONVERTORS ANCILLARY HALF SHEET 44INX58IN FAN FOLD NONWOVEN LF SMS STRL DISP (CDM 101205) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/101205?code_type=CDM
MLA (9th ed.)
“DRAPE SURG CONVERTORS ANCILLARY HALF SHEET 44INX58IN FAN FOLD NONWOVEN LF SMS STRL DISP (CDM 101205) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/101205?code_type=CDM. Accessed .
Chicago (notes-bibliography)
“DRAPE SURG CONVERTORS ANCILLARY HALF SHEET 44INX58IN FAN FOLD NONWOVEN LF SMS STRL DISP (CDM 101205) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/101205?code_type=CDM.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $2–$765 (25th–75th percentile) across 7 hospitals · 76 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CDM 101205 — 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 |
|---|---|---|---|---|---|---|---|
| Davie Medical Center OutpatientFacility | Aetna North Carolina Preferred | Behavioral Health | — | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| Davie Medical Center OutpatientFacility | Aetna | Behavioral Health | — | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Ambetter | Managed Care | — | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | United Healthcare | Managed Care | — | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | United Healthcare | Medicaid Managed Care | — | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | United Healthcare | IEX Individual Managed Care | — | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | United Healthcare | Medicare Advantage | — | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Cigna | Managed Care (Adult) | — | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Cigna | Managed Care (Pediatrics) | — | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Humana | Transplant Services | — | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Humana | Medicare Advantage | — | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Carolina Complete | Medicaid Managed Care | — | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Amerihealth | Managed Care | — | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Amerihealth | Medicaid Managed Care | — | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Aetna | Medicare Advantage | — | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Aetna | Transplant Services | — | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Alliance | Medicaid Tailored Plan | — | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Blue Cross Blue Shield | Blue Local Individual | — | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Blue Cross Blue Shield | Blue Value | — | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Blue Cross Blue Shield | HMO/PPO | — | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Blue Cross Blue Shield | Blue Distinctions Transplant Services | — | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Blue Cross Blue Shield | HPN | — | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Magellan | Behavioral Health | — | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Wellcare | Medicare Advantage | — | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Blue Cross Blue Shield | Medicare Advantage | — | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Cigna Evernorth | Behavioral Health | — | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Liberty | Medicare Advantage | — | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Partners | Medicaid Tailored Plan | — | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Trillium | Medicaid Tailored Plan | — | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Vaya | Medicaid Tailored Plan | — | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | United Healthcare/Optum Behavioral Health | Behavioral Health | — | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Optum Transplant | Transplant Services | — | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Cigna LifeSource | Transplant Services | — | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Health Blue | Medicaid Managed Care | — | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | HealthTeam | Medicare Advantage | — | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Cigna Healthsprings | Behavioral Health | — | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Cigna Healthsprings | Medicare Advantage | — | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Aetna Whole Health | Behavioral Health | — | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Wellcare | Medicaid Managed Care | — | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Carolina Behavioral Health | Behavioral Health | — | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Devoted | Medicare Advantage | — | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Apex | Medicare Advantage | — | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Alignment Medicare | Medicare Advantage | — | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Superior Health Plan | STARPLUS | $0.34 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Superior Health Plan | CHIP | $0.34 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Superior Health Plan | STAR | $0.34 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Superior Health Plan | STARKids | $0.34 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Superior Health Plan | CHPFC | $0.34 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| Davie Medical Center OutpatientFacility | Cigna LifeSource | Transplant Services | $0.51 | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | First Carolina Care | Managed Care | $0.68 | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Private Healthcare Systems | Managed Care | $0.70 | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | First Health (Aetna) | Managed Care | $0.72 | $0.85 | $0.43 | 2025-10-21 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Community Health Choice MCD | STAR+PLUS | $0.74 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Community Health Choice MCD | CHIPPerinatal | $0.74 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Community Health Choice MCD | CHIP | $0.74 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Community Health Choice MCD | STAR | $0.74 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Amerigroup | MGMCD | $0.80 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Amerigroup | MCDCHIPBH | $0.80 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | BCBS | MyBlueHealth | $0.93 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Superior | HMO | $1.00 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Superior | EPO | $1.00 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | BCBS | BAV | $1.03 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Oscar | HIX | $1.12 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Cigna | CSN | $1.13 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Superior | ValueHMO | $1.13 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Cigna | OpenAccessPlus | $1.20 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | BCBS | HMO | $1.29 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | BCBS | EPOSOA | $1.32 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | BCBS | PPO | $1.34 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Texas Childrens Health Plans | STAR | $1.36 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Texas Childrens Health Plans | STARKIDS | $1.36 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | United | OptionsPPO | $1.39 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Aetna | QHPExchange | $1.41 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Cigna | PPO | $1.45 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Healthcare Highways | NarrowNetwork | $1.46 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Texas Childrens Health Plans | CHIP | $1.49 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Molina Healthcare | HIX | $1.54 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Evry Health | BroadNetwork | $1.56 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Humana | PPO | $1.83 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Humana | HMO | $1.83 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | BCBS | Traditional | $2.00 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Kelsey Care (Boon-Chapman) | COMM | $2.00 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Imagine Health | PPO | $2.00 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Aetna | COMM | $2.20 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Christus (USFHP) | TRICARE | $2.29 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Curative Administrators | COMM | $2.29 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | HealthSmart Preferred Care | ACCEL | $2.46 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Aetna | ASA | $2.56 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | United | GlobalAppendix | $2.57 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Fidelis SecureCare of TX | MGMCR | $2.57 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Averde Health | Commercial | $2.57 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Aetna | OON | $2.59 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Multiplan | SAVILITYNETWORK | $2.86 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Coventry National First Health | COMM | $3.05 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Physicians Cooperative of Texas | WC | $3.15 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Rockport Workers Comp | COMM | $3.15 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Beech Street | WCOMP | $3.43 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | National Healthcare Solutions | COMM | $3.43 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | SouthWest Medical | WORKERSCOMP | $3.43 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Independent Medical System | COMM | $3.43 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Coastal Comp | COMM | $3.72 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Fiesta Mart, Inc | COMM | $4.29 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Affiliated PPO | COMM | $4.29 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Beech Street | COMMPPO | $4.58 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | HealthSmart Preferred Care | PPO | $4.69 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | HealthSmart Preferred Care | ACCOUNTABLEPPO | $4.86 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Physicians, INC | COMM | $4.86 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Multiplan | COMPLEMENTARYPPO | $5.15 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE PEARLAND Outpatient | Superior Health Plan | CHIP | $105.24 | $1,754.00 | $1,754.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE PEARLAND Outpatient | Superior Health Plan | CHPFC | $105.24 | $1,754.00 | $1,754.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE PEARLAND Outpatient | Superior Health Plan | STARKids | $105.24 | $1,754.00 | $1,754.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE PEARLAND Outpatient | Superior Health Plan | STAR | $105.24 | $1,754.00 | $1,754.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE PEARLAND Outpatient | Superior Health Plan | STARPLUS | $105.24 | $1,754.00 | $1,754.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CONROE Outpatient | Superior Health Plan | STARPLUS | $108.78 | $1,813.00 | $1,813.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CONROE Outpatient | Superior Health Plan | CHPFC | $108.78 | $1,813.00 | $1,813.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CONROE Outpatient | Superior Health Plan | STAR | $108.78 | $1,813.00 | $1,813.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CONROE Outpatient | Superior Health Plan | CHIP | $108.78 | $1,813.00 | $1,813.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CONROE Outpatient | Superior Health Plan | STARKids | $108.78 | $1,813.00 | $1,813.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE PEARLAND Outpatient | Aetna | MCR | $116.29 | $1,754.00 | $1,754.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CONROE Outpatient | Aetna | MCR | $120.20 | $1,813.00 | $1,813.00 | 2026-03-01 | MRF ↗ |
| VALLEY REGIONAL MEDICAL CENTER Outpatient | Superior Health Plan | CHPFC | $205.99 | $2,942.66 | $2,942.66 | 2026-03-01 | MRF ↗ |
| VALLEY REGIONAL MEDICAL CENTER Outpatient | Superior Health Plan | CHIP | $205.99 | $2,942.66 | $2,942.66 | 2026-03-01 | MRF ↗ |
| VALLEY REGIONAL MEDICAL CENTER Outpatient | Superior Health Plan | STAR | $205.99 | $2,942.66 | $2,942.66 | 2026-03-01 | MRF ↗ |
| VALLEY REGIONAL MEDICAL CENTER Outpatient | Superior Health Plan | STARPLUS | $205.99 | $2,942.66 | $2,942.66 | 2026-03-01 | MRF ↗ |
| VALLEY REGIONAL MEDICAL CENTER Outpatient | Superior Health Plan | STARKids | $205.99 | $2,942.66 | $2,942.66 | 2026-03-01 | MRF ↗ |
| TRISTAR GREENVIEW REGIONAL HOSPITAL Outpatient | Anthem BCBS | MGMCD | $222.25 | $3,175.00 | $3,175.00 | 2024-10-01 | MRF ↗ |
| TRISTAR GREENVIEW REGIONAL HOSPITAL Outpatient | United | MGMCD | $222.25 | $3,175.00 | $3,175.00 | 2024-10-01 | MRF ↗ |
| TRISTAR GREENVIEW REGIONAL HOSPITAL Outpatient | Molina | MCD | $222.25 | $3,175.00 | $3,175.00 | 2024-10-01 | MRF ↗ |
| TRISTAR GREENVIEW REGIONAL HOSPITAL Outpatient | Humana CareSource | MGMCD | $224.47 | $3,175.00 | $3,175.00 | 2024-10-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE PEARLAND Outpatient | Community Health Choice MCD | CHIP | $228.02 | $1,754.00 | $1,754.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE PEARLAND Outpatient | Community Health Choice MCD | CHIPPerinatal | $228.02 | $1,754.00 | $1,754.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE PEARLAND Outpatient | Community Health Choice MCD | STAR | $228.02 | $1,754.00 | $1,754.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE PEARLAND Outpatient | Community Health Choice MCD | STAR+PLUS | $228.02 | $1,754.00 | $1,754.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CONROE Outpatient | Community Health Choice MCD | CHIP | $235.69 | $1,813.00 | $1,813.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CONROE Outpatient | Community Health Choice MCD | STAR | $235.69 | $1,813.00 | $1,813.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CONROE Outpatient | Community Health Choice MCD | CHIPPerinatal | $235.69 | $1,813.00 | $1,813.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CONROE Outpatient | Community Health Choice MCD | STAR+PLUS | $235.69 | $1,813.00 | $1,813.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CONROE Outpatient | Amerigroup | MCDCHIPBH | $253.82 | $1,813.00 | $1,813.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CONROE Outpatient | Amerigroup | MGMCD | $253.82 | $1,813.00 | $1,813.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE PEARLAND Outpatient | Cigna | CSN | $259.59 | $1,754.00 | $1,754.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CONROE Outpatient | Cigna | CSN | $268.32 | $1,813.00 | $1,813.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE PEARLAND Outpatient | Cigna | OpenAccessPlus | $280.64 | $1,754.00 | $1,754.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE PEARLAND Outpatient | BCBS | MyBlueHealth | $285.90 | $1,754.00 | $1,754.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CONROE Outpatient | Cigna | OpenAccessPlus | $290.08 | $1,813.00 | $1,813.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE PEARLAND Outpatient | Texas Childrens Health Plans | CHIP | $291.16 | $1,754.00 | $1,754.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE PEARLAND Outpatient | United | OptionsPPO | $294.67 | $1,754.00 | $1,754.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CONROE Outpatient | BCBS | MyBlueHealth | $295.52 | $1,813.00 | $1,813.00 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Texas Athletic Network | Premier | $300.00 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| VALLEY REGIONAL MEDICAL CENTER Outpatient | Texas Athletic Network | Premier | $300.00 | $2,942.66 | $2,942.66 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CONROE Outpatient | Texas Athletic Network | Premier | $300.00 | $1,813.00 | $1,813.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE PEARLAND Outpatient | Superior | HMO | $306.95 | $1,754.00 | $1,754.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE PEARLAND Outpatient | Superior | EPO | $306.95 | $1,754.00 | $1,754.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE PEARLAND Outpatient | BCBS | BAV | $315.72 | $1,754.00 | $1,754.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CONROE Outpatient | Superior | HMO | $317.27 | $1,813.00 | $1,813.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CONROE Outpatient | Superior | EPO | $317.27 | $1,813.00 | $1,813.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CONROE Outpatient | United | OptionsPPO | $319.09 | $1,813.00 | $1,813.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CONROE Outpatient | BCBS | BAV | $326.34 | $1,813.00 | $1,813.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE PEARLAND Outpatient | Cigna | PPO | $333.26 | $1,754.00 | $1,754.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE PEARLAND Outpatient | Oscar | HIX | $342.03 | $1,754.00 | $1,754.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CONROE Outpatient | Cigna | PPO | $344.47 | $1,813.00 | $1,813.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE PEARLAND Outpatient | Superior | ValueHMO | $347.29 | $1,754.00 | $1,754.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CONROE Outpatient | Oscar | HIX | $353.54 | $1,813.00 | $1,813.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CONROE Outpatient | Superior | ValueHMO | $358.97 | $1,813.00 | $1,813.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CONROE Outpatient | Texas Childrens Health Plans | CHIP | $369.85 | $1,813.00 | $1,813.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE PEARLAND Outpatient | BCBS | HMO | $394.65 | $1,754.00 | $1,754.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE PEARLAND Outpatient | BCBS | EPOSOA | $403.42 | $1,754.00 | $1,754.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CONROE Outpatient | BCBS | HMO | $407.93 | $1,813.00 | $1,813.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE PEARLAND Outpatient | BCBS | PPO | $410.44 | $1,754.00 | $1,754.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE PEARLAND Outpatient | Texas Childrens Health Plans | STARKIDS | $415.70 | $1,754.00 | $1,754.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE PEARLAND Outpatient | Texas Childrens Health Plans | STAR | $415.70 | $1,754.00 | $1,754.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CONROE Outpatient | BCBS | EPOSOA | $416.99 | $1,813.00 | $1,813.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CONROE Outpatient | BCBS | PPO | $424.24 | $1,813.00 | $1,813.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CONROE Outpatient | Texas Childrens Health Plans | STAR | $429.68 | $1,813.00 | $1,813.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CONROE Outpatient | Texas Childrens Health Plans | STARKIDS | $429.68 | $1,813.00 | $1,813.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CONROE Outpatient | TX Workforce Commission | GVT | $435.12 | $1,813.00 | $1,813.00 | 2026-03-01 | MRF ↗ |
| TRISTAR GREENVIEW REGIONAL HOSPITAL Outpatient | Coventry Cares | MCD | $444.50 | $3,175.00 | $3,175.00 | 2024-10-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE PEARLAND Outpatient | Healthcare Highways | NarrowNetwork | $447.27 | $1,754.00 | $1,754.00 | 2026-03-01 | MRF ↗ |
| VALLEY REGIONAL MEDICAL CENTER Outpatient | BCBS | BlueAdvantage | $453.17 | $2,942.66 | $2,942.66 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CONROE Outpatient | Healthcare Highways | NarrowNetwork | $462.31 | $1,813.00 | $1,813.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE PEARLAND Outpatient | Aetna | QHPExchange | $464.81 | $1,754.00 | $1,754.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE PEARLAND Outpatient | Molina Healthcare | HIX | $473.58 | $1,754.00 | $1,754.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE PEARLAND Outpatient | Evry Health | BroadNetwork | $478.84 | $1,754.00 | $1,754.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CONROE Outpatient | Aetna | QHPExchange | $480.44 | $1,813.00 | $1,813.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CONROE Outpatient | Molina Healthcare | HIX | $489.51 | $1,813.00 | $1,813.00 | 2026-03-01 | MRF ↗ |
| TRISTAR GREENVIEW REGIONAL HOSPITAL Outpatient | Prime Health | WORKERSCOMP | $490.22 | $3,175.00 | $3,175.00 | 2024-10-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CONROE Outpatient | Evry Health | BroadNetwork | $494.95 | $1,813.00 | $1,813.00 | 2026-03-01 | MRF ↗ |
| VALLEY REGIONAL MEDICAL CENTER Outpatient | Texas Athletic Network | PremierPlus | $500.00 | $2,942.66 | $2,942.66 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CONROE Outpatient | Texas Athletic Network | PremierPlus | $500.00 | $1,813.00 | $1,813.00 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Texas Athletic Network | PremierPlus | $500.00 | $5.72 | $5.72 | 2026-03-01 | MRF ↗ |
| VALLEY REGIONAL MEDICAL CENTER Outpatient | Superior | HIX | $514.97 | $2,942.66 | $2,942.66 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE PEARLAND Outpatient | Humana | PPO | $559.70 | $1,754.00 | $1,754.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE PEARLAND Outpatient | Humana | HMO | $559.70 | $1,754.00 | $1,754.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE PEARLAND Outpatient | Aetna | NBPOS | $563.03 | $1,754.00 | $1,754.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE PEARLAND Outpatient | Aetna | NBPPO | $563.03 | $1,754.00 | $1,754.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE PEARLAND Outpatient | Aetna | NBHMO | $563.03 | $1,754.00 | $1,754.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CONROE Outpatient | Humana | HMO | $578.53 | $1,813.00 | $1,813.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CONROE Outpatient | Humana | PPO | $578.53 | $1,813.00 | $1,813.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CONROE Outpatient | Aetna | NBPPO | $581.97 | $1,813.00 | $1,813.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CONROE Outpatient | Aetna | NBHMO | $581.97 | $1,813.00 | $1,813.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CONROE Outpatient | Aetna | NBPOS | $581.97 | $1,813.00 | $1,813.00 | 2026-03-01 | 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.