109616 — St Brst Bx 1st Lesion Lt
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). ST BRST BX 1ST LESION LT (CDM 109616) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/109616?code_type=CDM
MLA (9th ed.)
“ST BRST BX 1ST LESION LT (CDM 109616) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/109616?code_type=CDM. Accessed .
Chicago (notes-bibliography)
“ST BRST BX 1ST LESION LT (CDM 109616) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/109616?code_type=CDM.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $115–$4,543 (25th–75th percentile) across 4 hospitals · 67 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CDM 109616 — 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 |
|---|---|---|---|---|---|---|---|
| PRESENCE SAINT JOSEPH HOSPITAL - CHICAGO Outpatient | TRICARE | 2571_TRICARE OUTPATIENT 20231001 | $0.34 | $2.83 | $0.93 | 2026-01-01 | MRF ↗ |
| PRESENCE SAINT JOSEPH HOSPITAL - CHICAGO Outpatient | TRICARE | 2813_TRICARE INPATIENT 20241001 | $0.34 | $2.83 | $0.93 | 2026-01-01 | MRF ↗ |
| PRESENCE SAINT JOSEPH HOSPITAL - CHICAGO Outpatient | SMARTHEALTH | 2815_SMARTHEALTH INPATIENT 20241001 | $0.54 | $2.83 | $0.93 | 2026-01-01 | MRF ↗ |
| PRESENCE SAINT JOSEPH HOSPITAL - CHICAGO Outpatient | SMARTHEALTH | 2917_SMARTHEALTH OP 20250101 | $0.54 | $2.83 | $0.93 | 2026-01-01 | MRF ↗ |
| PRESENCE SAINT JOSEPH HOSPITAL - CHICAGO Outpatient | CIGNA ONE HEALTH | 2826_CIGNA ONE HEALTH 20241001 | $0.57 | $2.83 | $0.93 | 2026-01-01 | MRF ↗ |
| PRESENCE SAINT JOSEPH HOSPITAL - CHICAGO Outpatient | CIGNA IFP | 3019_JCIL CIGNA IFP 20250101 | $0.71 | $2.83 | $0.93 | 2026-01-01 | MRF ↗ |
| PRESENCE SAINT JOSEPH HOSPITAL - CHICAGO Outpatient | BCBS BCE | 2879_JCIL BLUE CROSS BLUE SHIELD BCE 20241001 | $0.74 | $2.83 | $0.93 | 2026-01-01 | MRF ↗ |
| PRESENCE SAINT JOSEPH HOSPITAL - CHICAGO Outpatient | BCBS BCS | 2832_JCIL BLUE CROSS BLUE SHIELD BCS 20241001 | $0.74 | $2.83 | $0.93 | 2026-01-01 | MRF ↗ |
| PRESENCE SAINT JOSEPH HOSPITAL - CHICAGO Outpatient | BCBS HMO | 2833_JCIL BLUE CROSS BLUE SHIELD HMO 20241001 | $0.91 | $2.83 | $0.93 | 2026-01-01 | MRF ↗ |
| PRESENCE SAINT JOSEPH HOSPITAL - CHICAGO Outpatient | CIGNA C5 | 3023_CIGNA C5 20250101 | $0.96 | $2.83 | $0.93 | 2026-01-01 | MRF ↗ |
| PRESENCE SAINT JOSEPH HOSPITAL - CHICAGO Outpatient | BCBS PPO | 2834_JCIL BLUE CROSS BLUE SHIELD PPO 20241001 | $1.02 | $2.83 | $0.93 | 2026-01-01 | MRF ↗ |
| PRESENCE SAINT JOSEPH HOSPITAL - CHICAGO Outpatient | AETNA | 2925_JCIL AETNA 20250201 | $1.67 | $2.83 | $0.93 | 2026-01-01 | MRF ↗ |
| PRESENCE SAINT JOSEPH HOSPITAL - CHICAGO Outpatient | UHC PPO | 3096_PFIL, PRIL, PSIL UNITED HEALTHCARE OPTIONS PPO 20250701 | $1.70 | $2.83 | $0.93 | 2026-01-01 | MRF ↗ |
| PRESENCE SAINT JOSEPH HOSPITAL - CHICAGO Outpatient | UHC CHOICE | 3095_PFIL, PRIL, PSIL UNITED HEALTHCARE 20250701 | $1.70 | $2.83 | $0.93 | 2026-01-01 | MRF ↗ |
| PRESENCE SAINT JOSEPH HOSPITAL - CHICAGO Outpatient | UHC CHOICE | 3093_JCIL UNITED HEALTHCARE 20250701 | $1.70 | $2.83 | $0.93 | 2026-01-01 | MRF ↗ |
| PRESENCE SAINT JOSEPH HOSPITAL - CHICAGO Outpatient | UHC PPO | 3094_JCIL UNITED HEALTHCARE OPTIONS PPO 20250701 | $1.70 | $2.83 | $0.93 | 2026-01-01 | MRF ↗ |
| PRESENCE SAINT JOSEPH HOSPITAL - CHICAGO Outpatient | CIGNA ONE HEALTH | 2758_PHIL CIGNA ONE HEALTH 20240101 | $1.95 | $2.83 | $0.93 | 2026-01-01 | MRF ↗ |
| PRESENCE SAINT JOSEPH HOSPITAL - CHICAGO Outpatient | HUMANA HMO | 2837_JCIL HUMANA HMO 20241001 | $2.01 | $2.83 | $0.93 | 2026-01-01 | MRF ↗ |
| PRESENCE SAINT JOSEPH HOSPITAL - CHICAGO Outpatient | HUMANA PPO | 2838_JCIL HUMANA PPO 20241001 | $2.12 | $2.83 | $0.93 | 2026-01-01 | MRF ↗ |
| PRESENCE SAINT JOSEPH HOSPITAL - CHICAGO Inpatient | HEALTHLINK PPO | 963_JCIL HEALTHLINK PPO 20160101 | $2.26 | $2.83 | $0.93 | 2026-01-01 | MRF ↗ |
| PRESENCE SAINT JOSEPH HOSPITAL - CHICAGO Outpatient | CIGNA | 3006_JCIL CIGNA 20250101 | $2.32 | $2.83 | $0.93 | 2026-01-01 | MRF ↗ |
| PRESENCE SAINT JOSEPH HOSPITAL - CHICAGO Both | CDM DEFAULT - NON-NEGOTIATED RATE | CDM DEFAULT - NON-NEGOTIATED RATE | $2.83 | $2.83 | $0.93 | 2026-01-01 | MRF ↗ |
| PRESENCE SAINT JOSEPH HOSPITAL - CHICAGO Inpatient | CIGNA/HEALTH PARTNERS | 2526_CIGNA/HEALTH PARTNERS NON-CONTRACTED 20210101 | $2.83 | $2.83 | $0.93 | 2026-01-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Regence Blue Shield | MGMCR | $50.00 | $5,392.00 | $5,392.00 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Intermountain Healthcare | HIX | — | $4,813.00 | $4,813.00 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Intermountain Healthcare | PPO | — | $4,813.00 | $4,813.00 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | DMBA | HMO | — | $4,813.00 | $4,813.00 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | DMBA | PPO | — | $4,813.00 | $4,813.00 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Mountain Health Co-Op | Group | — | $4,813.00 | $4,813.00 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Mountain Health Co-Op | Individual | — | $4,813.00 | $4,813.00 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | EverNorth BH | COMM | — | $4,813.00 | $4,813.00 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Doug Andrus Distributing | COMM | — | $4,813.00 | $4,813.00 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | First Choice Health Of Washington | WCOMP | — | $4,813.00 | $4,813.00 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | First Choice of the Midwest | COMM | — | $4,813.00 | $4,813.00 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Interwest Health | PPO | — | $4,813.00 | $4,813.00 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | PacificSource Health | CCNNetworks | — | $4,813.00 | $4,813.00 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | PacificSource Health | PPO | — | $4,813.00 | $4,813.00 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Select Health Idaho (EIRMC only) | PPO | — | $4,813.00 | $4,813.00 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Select Health Idaho (EIRMC only) | SelectMed | — | $4,813.00 | $4,813.00 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Select Health Idaho (EIRMC only) | HIX | — | $4,813.00 | $4,813.00 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Shashone-Bannock Tribal Health | FED | — | $4,813.00 | $4,813.00 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Shashone-Bannock Tribal Health | MCR | — | $4,813.00 | $4,813.00 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | St. John's Health Network | COMM | — | $4,813.00 | $4,813.00 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Prime Health | WCOMP | — | $4,813.00 | $4,813.00 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Prime Health | INDIGENTCARE | — | $4,813.00 | $4,813.00 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | University of Utah | PPO | — | $4,813.00 | $4,813.00 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Cigna | PPO | — | $4,813.00 | $4,813.00 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Multiplan | PRIMARY | — | $4,813.00 | $4,813.00 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | University of Utah | HIX | — | $4,813.00 | $4,813.00 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Prime Health | GROUPHEALTH | — | $4,813.00 | $4,813.00 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Multiplan | COMPLEMENTARY | — | $4,813.00 | $4,813.00 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Blue Cross | QEP | — | $4,813.00 | $4,813.00 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Blue Cross | PPO | — | $4,813.00 | $4,813.00 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Blue Cross | POS | — | $4,813.00 | $4,813.00 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | University of Utah | HMP | — | $4,813.00 | $4,813.00 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | United | OptionsPPO | — | $4,813.00 | $4,813.00 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Molina | HIX | — | $4,813.00 | $4,813.00 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Blue Cross | ConnectedCare | — | $4,813.00 | $4,813.00 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Blue Cross | QHP | — | $4,813.00 | $4,813.00 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Blue Cross | TRAD | — | $4,813.00 | $4,813.00 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Aetna | CWI | — | $4,813.00 | $4,813.00 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Aetna | IdahoEnvironmentalCoalition | — | $4,813.00 | $4,813.00 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Aetna | PEAKPERFERENCE | — | $4,813.00 | $4,813.00 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Coventry First Health | WCOMP | — | $4,813.00 | $4,813.00 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Coventry First Health | COMM | — | $4,813.00 | $4,813.00 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | TriWest Healthcare Alliance | Veterans | — | $4,813.00 | $4,813.00 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | GEHA PPO USA | COMM | — | $4,813.00 | $4,813.00 | 2024-10-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Superior Health Plan | CHIP | $526.00 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Superior Health Plan | CHPFC | $526.00 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Superior Health Plan | STAR | $526.00 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Superior Health Plan | STARPLUS | $526.00 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Amerigroup | CHIP | $1,472.80 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Amerigroup | MCD | $1,472.80 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | BCBS | MyBlueHealth | $1,567.48 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Select Health ICHN Brightpath | PPO | $1,633.78 | $5,392.00 | $5,392.00 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Select Health | HIX | $1,633.78 | $5,392.00 | $5,392.00 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Select Health | PPO | $1,633.78 | $5,392.00 | $5,392.00 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Select Health Idaho (EIRMC only) | SelectMed | $1,720.05 | $5,392.00 | $5,392.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Superior Health Plan | AmbetterHMO | $1,788.40 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Superior Health Plan | AmbetterEPO | $1,788.40 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Superior Health Plan | ValueHMO | $1,788.40 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Select Health ICHN Brightpath | MED | $1,822.50 | $5,392.00 | $5,392.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | BCBS | BlueAdvantage | $1,841.00 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Imperial Insurance | MGMCR | $1,998.80 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Aetna | IdahoEnvironmentalCoalition | $2,124.45 | $5,392.00 | $5,392.00 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Doug Andrus Distributing | COMM | $2,156.80 | $5,392.00 | $5,392.00 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | University of Utah | PPO | $2,264.64 | $5,392.00 | $5,392.00 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | University of Utah | HIX | $2,264.64 | $5,392.00 | $5,392.00 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | PacificSource Health | CCNNetworks | $2,264.64 | $5,392.00 | $5,392.00 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | University of Utah | HMP | $2,264.64 | $5,392.00 | $5,392.00 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Aetna | CWI | $2,426.40 | $5,392.00 | $5,392.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | MODA | HIX | $2,472.20 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | United | OptionsPPO | $2,619.48 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Aetna | PEAKPERFERENCE | $2,625.90 | $5,392.00 | $5,392.00 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Mountain Health Co-Op | Individual | $2,696.00 | $5,392.00 | $5,392.00 | 2026-03-01 | MRF ↗ |
| EASTLAND MEMORIAL HOSPITAL Outpatient | United Healthcare | Medicare Advantage | $2,735.00 | $4,411.00 | $2,206.00 | 2026-06-26 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Blue Cross | TRAD | $2,868.54 | $5,392.00 | $5,392.00 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Blue Cross | POS | $2,868.54 | $5,392.00 | $5,392.00 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Blue Cross | PPO | $2,868.54 | $5,392.00 | $5,392.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | BCBS | BlueEssentialsAccess | $2,871.96 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | BCBS | BlueEssentials | $2,871.96 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | PacificSource Health | PPO | $2,890.11 | $5,392.00 | $5,392.00 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Cigna | PPO | $2,965.60 | $5,392.00 | $5,392.00 | 2026-03-01 | MRF ↗ |
| EASTLAND MEMORIAL HOSPITAL Outpatient | Blue Cross Blue Shield | Blue Essentials HMO | $2,999.00 | $4,411.00 | $2,206.00 | 2026-06-26 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Cigna Lifesource | COMM | $3,050.80 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | BCBS | EPOSOA | $3,113.92 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | United | OptionsPPO | $3,116.58 | $5,392.00 | $5,392.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | IMO Med - Select Network | WC | $3,156.00 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | First Choice Health Of Washington | WCOMP | $3,235.20 | $5,392.00 | $5,392.00 | 2026-03-01 | MRF ↗ |
| EASTLAND MEMORIAL HOSPITAL Outpatient | Blue Cross Blue Shield | PPO | $3,308.00 | $4,411.00 | $2,206.00 | 2026-06-26 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | BCBS | Traditional | $3,355.88 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | BCBS | PPO | $3,355.88 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Moda | COMM | $3,359.22 | $5,392.00 | $5,392.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Nomi Health | COMMTier1OutofNetwork | $3,366.40 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Sendero | ACHP | $3,366.40 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Cigna | NewBusinessNetwork | $3,376.92 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | DMBA | HMO | $3,472.45 | $5,392.00 | $5,392.00 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | DMBA | PPO | $3,472.45 | $5,392.00 | $5,392.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Cigna | HMO | $3,597.84 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Cigna | OpenAccessPlus | $3,597.84 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Cigna | OpenAccess | $3,597.84 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Shared Health | MGMCR | $3,682.00 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Aetna | QHPExchange(HIX) | $3,713.56 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | MODA Health | EPO | $3,787.20 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Evry Health | BroadNetwork | $3,871.36 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | MODA Health | PPO | $3,892.40 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Nomi Health | Tier2OutofNetwork | $3,892.40 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Texas Healthcare Foundation HEB | WC | $3,892.40 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Texas Healthcare Foundation HEB | COMM | $3,892.40 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Nomi Health | COMMTier1 | $3,892.40 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| EASTLAND MEMORIAL HOSPITAL Outpatient | Scott and Whte | Commercial | $3,970.00 | $4,411.00 | $2,206.00 | 2026-06-26 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Prime Health | INDIGENTCARE | $4,044.00 | $5,392.00 | $5,392.00 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Mountain Health Co-Op | Group | $4,044.00 | $5,392.00 | $5,392.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Texas Workforce Commission | WCOMP | $4,102.80 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Harbor Health Team | COMMPPO | $4,208.00 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Curative Administrators | COMM | $4,208.00 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Cigna | PPO | $4,313.20 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | TriWest Healthcare Alliance | Veterans | $4,313.60 | $5,392.00 | $5,392.00 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | GEHA PPO USA | COMM | $4,313.60 | $5,392.00 | $5,392.00 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Multiplan | PRIMARY | $4,529.28 | $5,392.00 | $5,392.00 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Humana ChoiceCare | COMM | $4,529.28 | $5,392.00 | $5,392.00 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Prime Health | WCOMP | $4,583.20 | $5,392.00 | $5,392.00 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Prime Health | GROUPHEALTH | $4,583.20 | $5,392.00 | $5,392.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | United | GlobalBenefitPlan | $4,734.00 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Averde Health | COMM | $4,734.00 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Seven Corners | GVT | $4,734.00 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | NaphCare | MGMCR | $4,734.00 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Aetna | NarrowNetwork | $4,744.52 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | First Choice of the Midwest | COMM | $4,852.80 | $5,392.00 | $5,392.00 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Multiplan | COMPLEMENTARY | $4,852.80 | $5,392.00 | $5,392.00 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | St. John's Health Network | COMM | $4,852.80 | $5,392.00 | $5,392.00 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Interwest Health | PPO | $4,852.80 | $5,392.00 | $5,392.00 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Coventry First Health | WCOMP | $4,906.72 | $5,392.00 | $5,392.00 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Coventry First Health | COMM | $4,906.72 | $5,392.00 | $5,392.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Aetna | COMM | $4,933.88 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Aetna | Meritain | $4,933.88 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Blue Cross | ConnectedCare | $5,122.40 | $5,392.00 | $5,392.00 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Blue Cross | QEP | $5,122.40 | $5,392.00 | $5,392.00 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Blue Cross | QHP | $5,122.40 | $5,392.00 | $5,392.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | National ChoiceCare | WC | $5,260.00 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Austin FC | WORKERSCOMP | $5,260.00 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Comanche County | LOCALGOV | $5,260.00 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Emerging Therapy Solutions | MGMCR | $5,260.00 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Shashone-Bannock Tribal Health | MCR | $5,392.00 | $5,392.00 | $5,392.00 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Shashone-Bannock Tribal Health | FED | $5,392.00 | $5,392.00 | $5,392.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Aetna | ASA | $5,754.44 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Physicians Cooperative of Texas | WC | $5,786.00 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Independent Medical Systems | COMM | $5,786.00 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | HealthSmart Preferred Care | Accel | $5,786.00 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Aetna | OON | $5,807.04 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Prime Health | WC | $6,312.00 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | First Health | PPO | $6,627.60 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | National Health Care | COMM | $6,838.00 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Coastal Comp Health Networks | WORKERSCOMP | $6,838.00 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Emerging Therapy Solutions | COMM | $7,258.80 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | First Health | PPO | $7,290.36 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Occunet | COMM | $7,364.00 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Texas Municipal League | COMM | $7,364.00 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | First Health | PPO | $7,563.88 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Preferred Health Arrangement | COMM | $7,890.00 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | MedCorp Southwest | COMM | $7,890.00 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Rockport Healthcare Group | WORKERSCOMPRockportCommunityNetwork | $8,416.00 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | HealthSmart Preferred Care | COMM | $8,416.00 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Multiplan | COMMPPO | $9,468.00 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Rockport Healthcare Group | WORKERSCOMPNewtonHealthcareNetwork | $9,468.00 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Medical Control Network Solutions | MedicalControlNetwork | $9,468.00 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | BCE Emergis Corporation | COMMPPO | $9,468.00 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Optum | MCD | $10,520.00 | $10,520.00 | $10,520.00 | 2026-03-01 | MRF ↗ |