1103 — Amputation Non-lower Extremity M <52.50 Tier 1 B
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). Amputation non-lower extremity M <52.50 Tier 1 B (LOCAL 1103) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/1103?code_type=LOCAL
MLA (9th ed.)
“Amputation non-lower extremity M <52.50 Tier 1 B (LOCAL 1103) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/1103?code_type=LOCAL. Accessed .
Chicago (notes-bibliography)
“Amputation non-lower extremity M <52.50 Tier 1 B (LOCAL 1103) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/1103?code_type=LOCAL.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $39,258–$49,846 (25th–75th percentile) across 5 hospitals · 42 payers.
“Negotiated” is the hospital’s negotiated facility rate for this LOCAL 1103 — 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 |
|---|---|---|---|---|---|---|---|
| SWEETWATER HOSPITAL ASSOCIATION Both | — | — | — | $16.71 | $5.68 | 2026-04-22 | MRF ↗ |
| MARLETTE REGIONAL HOSPITAL Both | Medicare Manged Care Plans | HMO | $236.44 | $514.00 | $514.00 | 2025-01-25 | MRF ↗ |
| MARLETTE REGIONAL HOSPITAL Both | EBL | HMO | $380.36 | $514.00 | $514.00 | 2025-01-25 | MRF ↗ |
| MARLETTE REGIONAL HOSPITAL Both | Aetna | HMO | $424.05 | $514.00 | $514.00 | 2025-01-25 | MRF ↗ |
| MARLETTE REGIONAL HOSPITAL Both | HAP | PPO | $457.46 | $514.00 | $514.00 | 2025-01-25 | MRF ↗ |
| MARLETTE REGIONAL HOSPITAL Both | Priority Health | PPO | $462.60 | $514.00 | $514.00 | 2025-01-25 | MRF ↗ |
| MARLETTE REGIONAL HOSPITAL Both | United Health Care | PPO | $462.60 | $514.00 | $514.00 | 2025-01-25 | MRF ↗ |
| MARLETTE REGIONAL HOSPITAL Both | PHCS Multiplan | HMO | $462.60 | $514.00 | $514.00 | 2025-01-25 | MRF ↗ |
| MARLETTE REGIONAL HOSPITAL Both | Humana | HMO | $462.60 | $514.00 | $514.00 | 2025-01-25 | MRF ↗ |
| MARLETTE REGIONAL HOSPITAL Both | Cofinity | HMO | $478.53 | $514.00 | $514.00 | 2025-01-25 | MRF ↗ |
| MARLETTE REGIONAL HOSPITAL Both | Blue Cross | PPO | $512.41 | $514.00 | $514.00 | 2025-01-25 | MRF ↗ |
| Mount Sinai Rehabilitation Hospital Inc OutpatientFacility | Anthem Mediblue | Medicare Advantage | $33,426.52 | — | — | 2025-01-01 | MRF ↗ |
| Mount Sinai Rehabilitation Hospital Inc OutpatientFacility | Mount Carmel Health Plan | Medicare Advantage | $34,638.88 | — | — | 2025-01-01 | MRF ↗ |
| Mount Sinai Rehabilitation Hospital Inc OutpatientFacility | Aetna | Medicare Advantage | $34,638.88 | — | — | 2025-01-01 | MRF ↗ |
| Mount Sinai Rehabilitation Hospital Inc OutpatientFacility | Connecticare | Medicare Advantage | $34,638.88 | — | — | 2025-01-01 | MRF ↗ |
| Mount Sinai Rehabilitation Hospital Inc OutpatientFacility | Evercare | Medicare Advantage | $34,638.88 | — | — | 2025-01-01 | MRF ↗ |
| Mount Sinai Rehabilitation Hospital Inc OutpatientFacility | Health New England | Medicare Advantage | $34,638.88 | — | — | 2025-01-01 | MRF ↗ |
| Mount Sinai Rehabilitation Hospital Inc OutpatientFacility | Commonwealth Care Alliance | Medicare Advantage | $34,638.88 | — | — | 2025-01-01 | MRF ↗ |
| Mount Sinai Rehabilitation Hospital Inc OutpatientFacility | VACCN United | Veterans Affairs | $34,638.88 | — | — | 2025-01-01 | MRF ↗ |
| Mount Sinai Rehabilitation Hospital Inc OutpatientFacility | Wellcare | Medicare Advantage | $35,331.66 | — | — | 2025-01-01 | MRF ↗ |
| Mount Sinai Rehabilitation Hospital Inc OutpatientFacility | Cigna | Medicare Advantage | $35,678.05 | — | — | 2025-01-01 | MRF ↗ |
| Mount Sinai Rehabilitation Hospital Inc OutpatientFacility | Humana | Medicare Advantage | $36,024.44 | — | — | 2025-01-01 | MRF ↗ |
| Gateway Rehabilitation Hospital Inpatient | — | — | — | $38,025.07 | $38,025.07 | 2025-07-01 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Department Of Corrections | Network Provider | $39,258.14 | $39,258.14 | $39,258.14 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Molina | Health Exchange | $39,258.14 | $39,258.14 | $39,258.14 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Molina | Medicare | $39,258.14 | $39,258.14 | $39,258.14 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Medicare | Part A | $39,258.14 | $39,258.14 | $39,258.14 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Aetna | Medicare Advantage | $39,258.14 | $39,258.14 | $39,258.14 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Corvel | Commercial | $39,258.14 | $39,258.14 | $39,258.14 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Health Net | Medicare Advantage | $39,258.14 | $39,258.14 | $39,258.14 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Health Net | Medi-Connect Dual | $39,258.14 | $39,258.14 | $39,258.14 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Alignment Health Plan | Commercial | $39,258.14 | $39,258.14 | $39,258.14 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Redlands Community Hospital | Commercial | $39,258.14 | $39,258.14 | $39,258.14 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Wellpath | Loa | $39,258.14 | $39,258.14 | $39,258.14 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Humana Choice Care | Medicare Ppo Hmo Pos Pffs | $39,258.14 | $39,258.14 | $39,258.14 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Dignity Health | Dual | $39,258.14 | $39,258.14 | $39,258.14 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Dignity Health | Medicare Replacement | $39,258.14 | $39,258.14 | $39,258.14 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Dignity Health | Commercial | $39,258.14 | $39,258.14 | $39,258.14 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Universal Care | Medicare Replacement | $39,258.14 | $39,258.14 | $39,258.14 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Easy Choice | Commercial | $39,258.14 | $39,258.14 | $39,258.14 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Blue Shield California | Promise Health Medicare Replacement | $39,258.14 | $39,258.14 | $39,258.14 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Care 1St | Medicare Replacement | $39,258.14 | $39,258.14 | $39,258.14 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Inter Valley Health Plan | Medicare Replacement | $39,258.14 | $39,258.14 | $39,258.14 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Tricare West Healthnet | Commercial | $39,258.14 | $39,258.14 | $39,258.14 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Prime Care Medical Group | Medicare Replacement | $39,258.14 | $39,258.14 | $39,258.14 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Prime Care Medical Group | Medicare Replacement | $39,258.14 | $39,258.14 | $39,258.14 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | California Correctional Health | Commercial | $39,258.14 | $39,258.14 | $39,258.14 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Astiva Health | Medicare Replacement | $39,258.14 | $39,258.14 | $39,258.14 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | California Health Wellness | Medicare Replacement | $39,258.14 | $39,258.14 | $39,258.14 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Cental Health Plan | Medicare Replacement | $39,258.14 | $39,258.14 | $39,258.14 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Cental Health Plan | Commercial | $39,258.14 | $39,258.14 | $39,258.14 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | State Department Of Hospitals | Patton | $39,258.14 | $39,258.14 | $39,258.14 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Village Health | Medicare Replacement | $39,258.14 | $39,258.14 | $39,258.14 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | St Marys Medical Center | Medicare Replacement | $39,258.14 | $39,258.14 | $39,258.14 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Triwest Community Care Network Commercial | — | $39,258.14 | $39,258.14 | $39,258.14 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | United Health Care Pacificare | Medicare Replacement | $39,258.14 | $39,258.14 | $39,258.14 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Humana Choice Care | Medicare Ppo Hmo Pos Pffs | $40,068.36 | $40,068.36 | $40,068.36 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Dignity Health | Dual | $40,068.36 | $40,068.36 | $40,068.36 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Dignity Health | Commercial | $40,068.36 | $40,068.36 | $40,068.36 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Cental Health Plan | Medicare Replacement | $40,068.36 | $40,068.36 | $40,068.36 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Dignity Health | Medicare Replacement | $40,068.36 | $40,068.36 | $40,068.36 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Universal Care | Medicare Replacement | $40,068.36 | $40,068.36 | $40,068.36 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Cental Health Plan | Commercial | $40,068.36 | $40,068.36 | $40,068.36 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Easy Choice | Commercial | $40,068.36 | $40,068.36 | $40,068.36 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Blue Shield California | Promise Health Medicare Replacement | $40,068.36 | $40,068.36 | $40,068.36 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | State Department Of Hospitals | Patton | $40,068.36 | $40,068.36 | $40,068.36 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Triwest Community Care Network Commercial | — | $40,068.36 | $40,068.36 | $40,068.36 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Care 1St | Medicare Replacement | $40,068.36 | $40,068.36 | $40,068.36 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Inter Valley Health Plan | Medicare Replacement | $40,068.36 | $40,068.36 | $40,068.36 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Tricare West Healthnet | Commercial | $40,068.36 | $40,068.36 | $40,068.36 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Village Health | Medicare Replacement | $40,068.36 | $40,068.36 | $40,068.36 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Prime Care Medical Group | Medicare Replacement | $40,068.36 | $40,068.36 | $40,068.36 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Prime Care Medical Group | Medicare Replacement | $40,068.36 | $40,068.36 | $40,068.36 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | California Correctional Health | Commercial | $40,068.36 | $40,068.36 | $40,068.36 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Molina | Health Exchange | $40,068.36 | $40,068.36 | $40,068.36 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Molina | Medicare | $40,068.36 | $40,068.36 | $40,068.36 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Department Of Corrections | Network Provider | $40,068.36 | $40,068.36 | $40,068.36 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Medicare | Part A | $40,068.36 | $40,068.36 | $40,068.36 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Aetna | Medicare Advantage | $40,068.36 | $40,068.36 | $40,068.36 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Corvel | Commercial | $40,068.36 | $40,068.36 | $40,068.36 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Astiva Health | Medicare Replacement | $40,068.36 | $40,068.36 | $40,068.36 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Health Net | Medi-Connect Dual | $40,068.36 | $40,068.36 | $40,068.36 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Health Net | Medicare Advantage | $40,068.36 | $40,068.36 | $40,068.36 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | United Health Care Pacificare | Medicare Replacement | $40,068.36 | $40,068.36 | $40,068.36 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Alignment Health Plan | Commercial | $40,068.36 | $40,068.36 | $40,068.36 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | St Marys Medical Center | Medicare Replacement | $40,068.36 | $40,068.36 | $40,068.36 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Redlands Community Hospital | Commercial | $40,068.36 | $40,068.36 | $40,068.36 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | California Health Wellness | Medicare Replacement | $40,068.36 | $40,068.36 | $40,068.36 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Wellpath | Loa | $40,068.36 | $40,068.36 | $40,068.36 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Village Health | Medicare Replacement | $49,845.61 | $49,845.61 | $49,845.61 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Wellpath | Loa | $49,845.61 | $49,845.61 | $49,845.61 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | California Correctional Health | Commercial | $49,845.61 | $49,845.61 | $49,845.61 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | California Health Wellness | Medicare Replacement | $49,845.61 | $49,845.61 | $49,845.61 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | St Marys Medical Center | Medicare Replacement | $49,845.61 | $49,845.61 | $49,845.61 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Prime Care Medical Group | Medicare Replacement | $49,845.61 | $49,845.61 | $49,845.61 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | United Health Care Pacificare | Medicare Replacement | $49,845.61 | $49,845.61 | $49,845.61 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Cental Health Plan | Medicare Replacement | $49,845.61 | $49,845.61 | $49,845.61 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Triwest Community Care Network Commercial | — | $49,845.61 | $49,845.61 | $49,845.61 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Dignity Health | Commercial | $49,845.61 | $49,845.61 | $49,845.61 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Dignity Health | Medicare Replacement | $49,845.61 | $49,845.61 | $49,845.61 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Dignity Health | Dual | $49,845.61 | $49,845.61 | $49,845.61 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Molina | Health Exchange | $49,845.61 | $49,845.61 | $49,845.61 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Molina | Medicare | $49,845.61 | $49,845.61 | $49,845.61 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Universal Care | Medicare Replacement | $49,845.61 | $49,845.61 | $49,845.61 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Redlands Community Hospital | Commercial | $49,845.61 | $49,845.61 | $49,845.61 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Easy Choice | Commercial | $49,845.61 | $49,845.61 | $49,845.61 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Cental Health Plan | Commercial | $49,845.61 | $49,845.61 | $49,845.61 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Medicare | Part A | $49,845.61 | $49,845.61 | $49,845.61 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Health Net | Medi-Connect Dual | $49,845.61 | $49,845.61 | $49,845.61 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Blue Shield California | Promise Health Medicare Replacement | $49,845.61 | $49,845.61 | $49,845.61 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Aetna | Medicare Advantage | $49,845.61 | $49,845.61 | $49,845.61 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Department Of Corrections | Network Provider | $49,845.61 | $49,845.61 | $49,845.61 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Care 1St | Medicare Replacement | $49,845.61 | $49,845.61 | $49,845.61 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Alignment Health Plan | Commercial | $49,845.61 | $49,845.61 | $49,845.61 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Inter Valley Health Plan | Medicare Replacement | $49,845.61 | $49,845.61 | $49,845.61 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | State Department Of Hospitals | Patton | $49,845.61 | $49,845.61 | $49,845.61 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Tricare West Healthnet | Commercial | $49,845.61 | $49,845.61 | $49,845.61 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Corvel | Commercial | $49,845.61 | $49,845.61 | $49,845.61 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Humana Choice Care | Medicare Ppo Hmo Pos Pffs | $49,845.61 | $49,845.61 | $49,845.61 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Prime Care Medical Group | Medicare Replacement | $49,845.61 | $49,845.61 | $49,845.61 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Astiva Health | Medicare Replacement | $49,845.61 | $49,845.61 | $49,845.61 | 2026-07-15 | MRF ↗ |
| Ballard Rehabilitation Hospital Inpatient | Health Net | Medicare Advantage | $49,845.61 | $49,845.61 | $49,845.61 | 2026-07-15 | MRF ↗ |
| Mount Sinai Rehabilitation Hospital Inc OutpatientFacility | Innovative Health Plan | All Products | $69,277.76 | — | — | 2025-01-01 | MRF ↗ |
| Mount Sinai Rehabilitation Hospital Inc OutpatientFacility | Prime Health | All Products | $72,741.65 | — | — | 2025-01-01 | MRF ↗ |