120051 — Tc99m Disofenin Per Vial To 15
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). TC99M DISOFENIN PER VIAL TO 15 (CDM 120051) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/120051?code_type=CDM
MLA (9th ed.)
“TC99M DISOFENIN PER VIAL TO 15 (CDM 120051) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/120051?code_type=CDM. Accessed .
Chicago (notes-bibliography)
“TC99M DISOFENIN PER VIAL TO 15 (CDM 120051) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/120051?code_type=CDM.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $1–$123 (25th–75th percentile) across 6 hospitals · 60 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CDM 120051 — 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 | Behavioral Health | — | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center OutpatientFacility | Aetna North Carolina Preferred | Behavioral Health | — | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Wellcare | Medicaid Managed Care | — | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | United Healthcare/Optum Behavioral Health | Behavioral Health | — | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Optum Transplant | Transplant Services | — | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Cigna LifeSource | Transplant Services | — | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Ambetter | Managed Care | — | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Health Blue | Medicaid Managed Care | — | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | United Healthcare | IEX Individual Managed Care | — | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | United Healthcare | Medicare Advantage | — | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | HealthTeam | Medicare Advantage | — | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Cigna Healthsprings | Medicare Advantage | — | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Cigna Healthsprings | Behavioral Health | — | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Aetna Whole Health | Behavioral Health | — | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Alignment Medicare | Medicare Advantage | — | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Apex | Medicare Advantage | — | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Devoted | Medicare Advantage | — | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Cigna | Managed Care (Pediatrics) | — | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Wellcare | Medicare Advantage | — | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Humana | Transplant Services | — | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Cigna | Managed Care (Adult) | — | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | United Healthcare | Managed Care | — | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Carolina Behavioral Health | Behavioral Health | — | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Trillium | Medicaid Tailored Plan | — | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Partners | Medicaid Tailored Plan | — | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Liberty | Medicare Advantage | — | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Cigna Evernorth | Behavioral Health | — | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Blue Cross Blue Shield | Blue Local Individual | — | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Blue Cross Blue Shield | HMO/PPO | — | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Blue Cross Blue Shield | HPN | — | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Blue Cross Blue Shield | Blue Distinctions Transplant Services | — | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Blue Cross Blue Shield | Blue Value | — | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Blue Cross Blue Shield | Medicare Advantage | — | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Alliance | Medicaid Tailored Plan | — | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Aetna | Medicare Advantage | — | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Aetna | Transplant Services | — | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Magellan | Behavioral Health | — | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Amerihealth | Managed Care | — | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Amerihealth | Medicaid Managed Care | — | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | United Healthcare | Medicaid Managed Care | — | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Carolina Complete | Medicaid Managed Care | — | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Humana | Medicare Advantage | — | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Vaya | Medicaid Tailored Plan | — | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center OutpatientFacility | Cigna LifeSource | Transplant Services | $0.93 | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | First Carolina Care | Managed Care | $1.24 | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Private Healthcare Systems | Managed Care | $1.27 | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | First Health (Aetna) | Managed Care | $1.32 | $1.55 | $0.78 | 2025-10-21 | MRF ↗ |
| RIVERSIDE COMMUNITY HOSPITAL Outpatient | Aetna | MCRPPO | $1.80 | $18.00 | $18.00 | 2024-10-01 | MRF ↗ |
| RIVERSIDE COMMUNITY HOSPITAL Outpatient | Aetna | MCRHMO | $1.80 | $18.00 | $18.00 | 2024-10-01 | MRF ↗ |
| RIVERSIDE COMMUNITY HOSPITAL Outpatient | Aetna | MCRPOS | $1.80 | $18.00 | $18.00 | 2024-10-01 | MRF ↗ |
| RIVERSIDE COMMUNITY HOSPITAL Outpatient | MedCare Partners | MGMCR | $2.70 | $18.00 | $18.00 | 2024-10-01 | MRF ↗ |
| RIVERSIDE COMMUNITY HOSPITAL Outpatient | Imperial Insurance | MCR | $2.70 | $18.00 | $18.00 | 2024-10-01 | MRF ↗ |
| Riverside Community Hospital Outpatient | Imperial Insurance | MCR | $2.92 | $19.50 | $19.50 | 2026-03-01 | MRF ↗ |
| RIVERSIDE COMMUNITY HOSPITAL Outpatient | Aetna | PPO | $3.42 | $18.00 | $18.00 | 2024-10-01 | MRF ↗ |
| RIVERSIDE COMMUNITY HOSPITAL Outpatient | Aetna | HMO | $3.42 | $18.00 | $18.00 | 2024-10-01 | MRF ↗ |
| RIVERSIDE COMMUNITY HOSPITAL Outpatient | Health Net | COMM | $4.01 | $18.00 | $18.00 | 2024-10-01 | MRF ↗ |
| Riverside Community Hospital Outpatient | Health Net | COMM | $4.27 | $19.50 | $19.50 | 2026-03-01 | MRF ↗ |
| RIVERSIDE COMMUNITY HOSPITAL Outpatient | Cigna | PPO | $4.43 | $18.00 | $18.00 | 2024-10-01 | MRF ↗ |
| RIVERSIDE COMMUNITY HOSPITAL Outpatient | Cigna | HMO | $4.43 | $18.00 | $18.00 | 2024-10-01 | MRF ↗ |
| RIVERSIDE COMMUNITY HOSPITAL Outpatient | United | OptionsPPO | $5.20 | $18.00 | $18.00 | 2024-10-01 | MRF ↗ |
| RIVERSIDE COMMUNITY HOSPITAL Outpatient | Redlands Community | COMM | $5.40 | $18.00 | $18.00 | 2024-10-01 | MRF ↗ |
| RIVERSIDE COMMUNITY HOSPITAL Outpatient | Blue Shield | EPN | $5.93 | $18.00 | $18.00 | 2024-10-01 | MRF ↗ |
| RIVERSIDE COMMUNITY HOSPITAL Outpatient | Bright Health | COMM | $7.13 | $18.00 | $18.00 | 2024-10-01 | MRF ↗ |
| RIVERSIDE COMMUNITY HOSPITAL Outpatient | First Health | COMM | $7.92 | $18.00 | $18.00 | 2024-10-01 | MRF ↗ |
| RIVERSIDE COMMUNITY HOSPITAL Outpatient | American Health System | HIX | $8.10 | $18.00 | $18.00 | 2024-10-01 | MRF ↗ |
| RIVERSIDE COMMUNITY HOSPITAL Outpatient | Emerging Therapy Solutions | MCR | $9.00 | $18.00 | $18.00 | 2024-10-01 | MRF ↗ |
| RIVERSIDE COMMUNITY HOSPITAL Outpatient | Blue Shield | Comm | $9.56 | $18.00 | $18.00 | 2024-10-01 | MRF ↗ |
| RIVERSIDE COMMUNITY HOSPITAL Outpatient | Riverside Medical Clinic | COMM | $11.70 | $18.00 | $18.00 | 2024-10-01 | MRF ↗ |
| RIVERSIDE COMMUNITY HOSPITAL Outpatient | Riverside Medical Clinic | MCR | $11.70 | $18.00 | $18.00 | 2024-10-01 | MRF ↗ |
| RIVERSIDE COMMUNITY HOSPITAL Outpatient | Riverside Physician | MCR | $11.70 | $18.00 | $18.00 | 2024-10-01 | MRF ↗ |
| RIVERSIDE COMMUNITY HOSPITAL Outpatient | Networks by Design | COMM | $12.24 | $18.00 | $18.00 | 2024-10-01 | MRF ↗ |
| RIVERSIDE COMMUNITY HOSPITAL Outpatient | Emerging Therapy Solutions | Commercial | $13.50 | $18.00 | $18.00 | 2024-10-01 | MRF ↗ |
| RIVERSIDE COMMUNITY HOSPITAL Outpatient | HealthSmart | COMM | $14.40 | $18.00 | $18.00 | 2024-10-01 | MRF ↗ |
| RIVERSIDE COMMUNITY HOSPITAL Outpatient | Multiplan | COMMCOMPLEMENTARYPPO | $14.40 | $18.00 | $18.00 | 2024-10-01 | MRF ↗ |
| RIVERSIDE COMMUNITY HOSPITAL Outpatient | Next | COMMPPO | $14.40 | $18.00 | $18.00 | 2024-10-01 | MRF ↗ |
| RIVERSIDE COMMUNITY HOSPITAL Outpatient | Multiplan | COMMPRIMARYPPO | $15.30 | $18.00 | $18.00 | 2024-10-01 | MRF ↗ |
| RIVERSIDE COMMUNITY HOSPITAL Outpatient | First Health | WCOMP | $16.20 | $18.00 | $18.00 | 2024-10-01 | MRF ↗ |
| RIVERSIDE COMMUNITY HOSPITAL Outpatient | Heritage Provider Network | COMM | $24.66 | $18.00 | $18.00 | 2024-10-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | US HEALTH AND LIFE | 1991_BOMC, BOLE, BPHC US HEALTH AND LIFE 20200101 | $43.22 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | US HEALTH AND LIFE | 1991_BOMC, BOLE, BPHC US HEALTH AND LIFE 20200101 | $43.22 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | US HEALTH AND LIFE | 1991_BOMC, BOLE, BPHC US HEALTH AND LIFE 20200101 | $43.22 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | SMARTHEALTH | 3501_SMARTHEALTH 20230101 | $46.30 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | SMARTHEALTH | 3501_SMARTHEALTH 20230101 | $46.30 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | SMARTHEALTH | 3501_SMARTHEALTH 20230101 | $46.30 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | PRIORITY HEALTH APPLE | 2606_BOMC, BPHC PRIORITY HEALTH APPLE 20200101 | $67.91 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | PRIORITY HEALTH APPLE | 2606_BOMC, BPHC PRIORITY HEALTH APPLE 20200101 | $67.91 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | PRIORITY HEALTH APPLE | 2606_BOMC, BPHC PRIORITY HEALTH APPLE 20200101 | $67.91 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | COFINITY ADVANTAGE | 2002_COFINITY ADVANTAGE 20200101 | $75.63 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | COFINITY ADVANTAGE | 2002_COFINITY ADVANTAGE 20200101 | $75.63 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | COFINITY ADVANTAGE | 2002_COFINITY ADVANTAGE 20200101 | $75.63 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ALLEGAN MEDICARE | 3127_BOAH MEDICARE OUTPATIENT 20231001 | $81.81 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | ALLEGAN MOLINA MEDICARE | 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215 | $81.81 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | ALLEGAN MEDICARE | 3127_BOAH MEDICARE OUTPATIENT 20231001 | $81.81 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | ALLEGAN HUMANA MCR | 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001 | $81.81 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ALLEGAN MOLINA MEDICARE | 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215 | $81.81 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ALLEGAN HUMANA MCR | 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001 | $81.81 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | AUTO MVA | 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215 | $81.81 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | AUTO MVA | 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215 | $81.81 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ALLEGAN MEDICARE | 3127_BOAH MEDICARE OUTPATIENT 20231001 | $81.81 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ALLEGAN HUMANA MCR | 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001 | $81.81 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ALLEGAN MOLINA MEDICARE | 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215 | $81.81 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | AUTO MVA | 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215 | $81.81 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | PRIORITY HEALTH HMO/PPO | 2404_BOGI BOSU PRIORITY HEALTH 20200401 | $92.61 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | CIGNA | 2827_BOGI BOSU CIGNA 20210912 | $92.61 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | PRIORITY HEALTH HMO/PPO | 2404_BOGI BOSU PRIORITY HEALTH 20200401 | $92.61 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | PRIORITY HEALTH HMO/PPO | 2404_BOGI BOSU PRIORITY HEALTH 20200401 | $92.61 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | CIGNA | 2827_BOGI BOSU CIGNA 20210912 | $92.61 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | MAGELLAN | 2050_BOMC, BPHC MAGELLAN 20210201 | $92.61 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | MAGELLAN | 2050_BOMC, BPHC MAGELLAN 20210201 | $92.61 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | CIGNA | 2827_BOGI BOSU CIGNA 20210912 | $92.61 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | MAGELLAN | 2050_BOMC, BPHC MAGELLAN 20210201 | $92.61 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | COFINITY | 1993_BOMC, BPHC COFINITY PPOM 20200101 | $106.50 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | COFINITY | 1993_BOMC, BPHC COFINITY PPOM 20200101 | $106.50 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | COFINITY | 1993_BOMC, BPHC COFINITY PPOM 20200101 | $106.50 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | PHCS | 1995_BOMC, BPHC PHCS 20200101 | $115.76 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | PHCS | 1971_BOGI, BOSU PHCS 20200101 | $115.76 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | PHCS | 1995_BOMC, BPHC PHCS 20200101 | $115.76 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | PHCS | 1971_BOGI, BOSU PHCS 20200101 | $115.76 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | PHCS | 1995_BOMC, BPHC PHCS 20200101 | $115.76 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | PHCS | 1971_BOGI, BOSU PHCS 20200101 | $115.76 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ALLEGAN UHC | 3184_BOAH UNITED HEALTH CARE 20240701 | $118.85 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | ALLEGAN UHC | 3184_BOAH UNITED HEALTH CARE 20240701 | $118.85 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ALLEGAN UHC | 3184_BOAH UNITED HEALTH CARE 20240701 | $118.85 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | BC OF MICH TRAD | 3494_BOAH BLUE CROSS TRUST 20240701 | $120.39 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | CIGNA ALLEGAN | 3180_BOAH CIGNA 20230701 | $120.39 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | BCBS ALL OTHER | 3496_BOAH BLUE CROSS TRADITIONAL 20240701 | $120.39 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | CIGNA ALLEGAN | 3180_BOAH CIGNA 20230701 | $120.39 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | BCBS ALL OTHER | 3496_BOAH BLUE CROSS TRADITIONAL 20240701 | $120.39 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | BC OF MICH TRAD | 3494_BOAH BLUE CROSS TRUST 20240701 | $120.39 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | BCBS ALL OTHER | 3496_BOAH BLUE CROSS TRADITIONAL 20240701 | $120.39 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | BC OF MICH TRAD | 3494_BOAH BLUE CROSS TRUST 20240701 | $120.39 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | CIGNA ALLEGAN | 3180_BOAH CIGNA 20230701 | $120.39 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ALLEGAN PRIORITY HEALTH HMO AND PPO | 3126_BOAH PRIORITY HEALTH HMO AND PPO 20100101 | $121.94 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | ALLEGAN PRIORITY HEALTH HMO AND PPO | 3126_BOAH PRIORITY HEALTH HMO AND PPO 20100101 | $121.94 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ALLEGAN PRIORITY HEALTH HMO AND PPO | 3126_BOAH PRIORITY HEALTH HMO AND PPO 20100101 | $121.94 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | COFINITY | 1969_BOGI, BOSU COFINITY 20200101 | $123.48 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | COFINITY | 1969_BOGI, BOSU COFINITY 20200101 | $123.48 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ASR CORP | 2588_BOMC, BPHC, BOLE ASR CORP 20200101 | $123.48 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | FIRST HEALTH | 1994_BOMC, BPHC, BOSU, BOGI FIRST HEALTH 20200101 | $123.48 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | FIRST HEALTH | 1994_BOMC, BPHC, BOSU, BOGI FIRST HEALTH 20200101 | $123.48 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | ASR CORP | 2588_BOMC, BPHC, BOLE ASR CORP 20200101 | $123.48 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ASR CORP | 2588_BOMC, BPHC, BOLE ASR CORP 20200101 | $123.48 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | COFINITY | 1969_BOGI, BOSU COFINITY 20200101 | $123.48 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | FIRST HEALTH | 1994_BOMC, BPHC, BOSU, BOGI FIRST HEALTH 20200101 | $123.48 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | HEALTHSCOPE | 1989_BOMC, BOLE, BPHC HEALTHSCOPE 20200101 | $126.57 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | HEALTHSCOPE | 1989_BOMC, BOLE, BPHC HEALTHSCOPE 20200101 | $126.57 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | HEALTHSCOPE | 1989_BOMC, BOLE, BPHC HEALTHSCOPE 20200101 | $126.57 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | PREFERRED CHOICES | 2605_PREFERRED CHOICES 20200101 | $131.20 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | DIRECT CARE AMERICA | 2581_DIRECT CARE AMERICA 20200101 | $131.20 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | PREFERRED CHOICES | 2605_PREFERRED CHOICES 20200101 | $131.20 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | DIRECT CARE AMERICA | 2581_DIRECT CARE AMERICA 20200101 | $131.20 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | PREFERRED CHOICES | 2605_PREFERRED CHOICES 20200101 | $131.20 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | DIRECT CARE AMERICA | 2581_DIRECT CARE AMERICA 20200101 | $131.20 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | MULTIPLAN | 2393_BOMC BPHC MULTIPLAN 20190101 | $135.83 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | MULTIPLAN | 2393_BOMC BPHC MULTIPLAN 20190101 | $135.83 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | MULTIPLAN | 2393_BOMC BPHC MULTIPLAN 20190101 | $135.83 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | COFINITY | 1975_BOLE COFINITY 20200101 | $138.91 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | COFINITY | 1975_BOLE COFINITY 20200101 | $138.91 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | HUMANA | 2623_BOMC, BOLE, BPHC HUMANA 20210401 | $138.91 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | COFINITY | 1975_BOLE COFINITY 20200101 | $138.91 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | HUMANA | 2623_BOMC, BOLE, BPHC HUMANA 20210401 | $138.91 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | HUMANA | 2623_BOMC, BOLE, BPHC HUMANA 20210401 | $138.91 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | CHA | 2589_BOMC, BPHC, BOLE CHA 20200101 | $142.00 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | CHA | 2589_BOMC, BPHC, BOLE CHA 20200101 | $142.00 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | CHA | 2589_BOMC, BPHC, BOLE CHA 20200101 | $142.00 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | HEALTHSCOPE | 2601_BOSU, BOGI HEALTHSCOPE 20200101 | $146.63 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | HEALTHSCOPE | 2601_BOSU, BOGI HEALTHSCOPE 20200101 | $146.63 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | ASR 2 | 1970_BOGI, BOSU HEALTHSCOPE 98R 20200101 | $146.63 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ASR 2 | 1970_BOGI, BOSU HEALTHSCOPE 98R 20200101 | $146.63 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | HEALTHSCOPE | 2601_BOSU, BOGI HEALTHSCOPE 20200101 | $146.63 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ASR CORP | 2602_BOSU, BOGI ASR CORP 20200101 | $146.63 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ASR 2 | 1970_BOGI, BOSU HEALTHSCOPE 98R 20200101 | $146.63 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ASR CORP | 2602_BOSU, BOGI ASR CORP 20200101 | $146.63 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | ASR CORP | 2602_BOSU, BOGI ASR CORP 20200101 | $146.63 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Both | CDM DEFAULT - NON-NEGOTIATED RATE | CDM DEFAULT - NON-NEGOTIATED RATE | $154.35 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Both | CDM DEFAULT - NON-NEGOTIATED RATE | CDM DEFAULT - NON-NEGOTIATED RATE | $154.35 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Both | CDM DEFAULT - NON-NEGOTIATED RATE | CDM DEFAULT - NON-NEGOTIATED RATE | $154.35 | $154.35 | $75.63 | 2026-01-01 | MRF ↗ |
| BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER, INC Both | Tricare | Commercial | $2,553.00 | $9,600.00 | $9,600.00 | 2025-11-07 | MRF ↗ |
| BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER, INC Both | Ambetter | Commercial | $9,024.00 | $9,600.00 | $9,600.00 | 2025-11-07 | MRF ↗ |
| BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER, INC Both | Midlands Choice | Commercial | $9,024.00 | $9,600.00 | $9,600.00 | 2025-11-07 | MRF ↗ |
| BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER, INC Both | Cigna | Commercial | $9,024.00 | $9,600.00 | $9,600.00 | 2025-11-07 | MRF ↗ |
| BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER, INC Both | Blue Cross Blue Shield | Commercial | $9,120.00 | $9,600.00 | $9,600.00 | 2025-11-07 | MRF ↗ |
| BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER, INC Both | Medica | Commercial | $9,120.00 | $9,600.00 | $9,600.00 | 2025-11-07 | MRF ↗ |
| BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER, INC Both | Aetna | Commercial | $9,216.00 | $9,600.00 | $9,600.00 | 2025-11-07 | MRF ↗ |
| BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER, INC Both | Coventry | Commercial | $9,216.00 | $9,600.00 | $9,600.00 | 2025-11-07 | MRF ↗ |
| BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER, INC Both | Meritain | Commercial | $9,216.00 | $9,600.00 | $9,600.00 | 2025-11-07 | MRF ↗ |