19304 — Mast Subq
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). Mast subq (HCPCS 19304) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/19304?code_type=HCPCS
MLA (9th ed.)
“Mast subq (HCPCS 19304) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/19304?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“Mast subq (HCPCS 19304) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/19304?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $1,298–$5,945 (25th–75th percentile) across 653 hospitals · 508 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 19304 — 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 |
|---|---|---|---|---|---|---|---|
| TEXAS SCOTTISH RITE HOSPITAL FOR CHILDREN Outpatient | BCBS BAV | BCBS BAV | $24.00 | $1,892.00 | $1,892.00 | 2026-02-09 | MRF ↗ |
| LOGAN REGIONAL HOSPITAL OutpatientFacility | None | — | — | — | — | 2026-03-23 | MRF ↗ |
| IOWA SPECIALTY HOSPITAL - CLARION Outpatient | MIDLANDS CHOICE-ALL PLANS | MIDLANDS CHOICE-ALL PLANS | $71.22 | $1,809.00 | $1,085.40 | 2026-04-22 | MRF ↗ |
| BELLEVUE MEDICAL CENTER Outpatient | AETNA-ALL PLANS | AETNA-ALL PLANS | $76.43 | $1,312.50 | $853.13 | 2025-12-29 | MRF ↗ |
| THE NEBRASKA MEDICAL CENTER Outpatient | AETNA-ALL PLANS | AETNA-ALL PLANS | $76.43 | $1,312.50 | $853.13 | 2026-01-05 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED CHICAGO TEACHER FUND-ALL PLANS | UNITED CHICAGO TEACHER FUND-ALL PLANS | $77.22 | $572.00 | $429.00 | 2026-01-16 | MRF ↗ |
| THE NEBRASKA MEDICAL CENTER Outpatient | MIDLANDS CHOICE-ALL PLANS | MIDLANDS CHOICE-ALL PLANS | $80.09 | $1,312.50 | $853.13 | 2026-01-05 | MRF ↗ |
| BELLEVUE MEDICAL CENTER Outpatient | MIDLANDS CHOICE-ALL PLANS | MIDLANDS CHOICE-ALL PLANS | $80.09 | $1,312.50 | $853.13 | 2025-12-29 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Caresource | Wv Marketplace | — | — | — | 2026-05-06 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED AT&T-ALL PLANS | UNITED AT&T-ALL PLANS | $118.69 | $572.00 | $429.00 | 2026-01-16 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | Managed Health Services | Medicaid | $134.40 | $640.71 | $538.20 | 2026-05-09 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | Anthem | Ppo Hmo Exchange | — | $640.71 | $538.20 | 2026-05-09 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | Consumer Life | Commercial | — | $640.71 | $538.20 | 2026-05-09 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | Coventry | Commercial | — | $640.71 | $538.20 | 2026-05-09 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | Humana Healthnet | Tricare | — | $640.71 | $538.20 | 2026-05-09 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | United Healthcare | Medicaid | $134.40 | $640.71 | $538.20 | 2026-05-09 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | Care Improvement Plus | Medicare Advantage | — | $640.71 | $538.20 | 2026-05-09 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | Encore | Ppo | — | $640.71 | $538.20 | 2026-05-09 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | Aetna | Medicare Advantage | — | $640.71 | $538.20 | 2026-05-09 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | Mdwise | Excel And Hoosier Healthwise | $134.40 | $640.71 | $538.20 | 2026-05-09 | MRF ↗ |
| Shepherd Center Outpatient | Aetna | Commercial | $136.83 | — | — | 2026-05-06 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Connecticut General Cigna | Default | — | $1,155.00 | $866.25 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | — | $1,155.00 | $866.25 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Primewell Vantage Health Plan | Default | — | $1,155.00 | $866.25 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Medicare B MS JH | Default | — | $1,155.00 | $866.25 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Advanced Health | Default | — | $1,155.00 | $866.25 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Blue Cross Blue Shield of MS INST | Default | $170.00 | $1,155.00 | $866.25 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Mississippi Physicians Care Network | Default | — | $1,155.00 | $866.25 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Medicare A MS JH | Default | — | $1,155.00 | $866.25 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | First Choice Health Network | Default | — | $1,155.00 | $866.25 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Mississippi Select Health Care | Default | — | $1,155.00 | $866.25 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | GEHA Multiplan Network | Default | — | $1,155.00 | $866.25 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | UHC Community Plan MS | Default | — | $1,155.00 | $866.25 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Magnolia Health Plan MCD Rep | Default | — | $1,155.00 | $866.25 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Medicaid Mississippi | Default | — | $1,155.00 | $866.25 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Private Healthcare Systems PHCS | Default | — | $1,155.00 | $866.25 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Multiplan Inc. for American Family | Default | — | $1,155.00 | $866.25 | 2025-03-07 | MRF ↗ |
| UCHEALTH BROOMFIELD HOSPITAL OutpatientFacility | Denver Health Medical Plan | Medicaid Choice | $186.59 | — | — | 2025-11-01 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | TRIWEST VA PCCC-ALL PLANS | TRIWEST VA PCCC-ALL PLANS | $211.56 | $1,675.29 | $1,172.70 | 2025-12-20 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | TRIWEST VA PCCC-ALL PLANS | TRIWEST VA PCCC-ALL PLANS | $211.56 | $1,675.29 | $1,172.70 | 2025-12-20 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | SUPERIOR ALLWELL MCR ADV-ALL OTHER PLANS | SUPERIOR ALLWELL MCR ADV-ALL OTHER PLANS | $215.88 | $1,675.29 | $1,172.70 | 2025-12-20 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | MULTIPLAN MCR ADV | MULTIPLAN MCR ADV | $215.88 | $1,675.29 | $1,172.70 | 2025-12-20 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | CARE IMPROVEMENT PLUS - ALL OTHER PLANS | CARE IMPROVEMENT PLUS - ALL OTHER PLANS | $215.88 | $1,675.29 | $1,172.70 | 2025-12-20 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | AMERIGROUP MCR ADV-ALL OTHER PLANS | AMERIGROUP MCR ADV-ALL OTHER PLANS | $215.88 | $1,675.29 | $1,172.70 | 2025-12-20 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | COVENTRY FIRST HLTH MCR ADV | COVENTRY FIRST HLTH MCR ADV | $215.88 | $1,675.29 | $1,172.70 | 2025-12-20 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | SUPERIOR ALLWELL MCR ADV-ALL OTHER PLANS | SUPERIOR ALLWELL MCR ADV-ALL OTHER PLANS | $215.88 | $1,675.29 | $1,172.70 | 2025-12-20 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | UNIVERSAL AMERICAN MCR-ALL OTHER PLANS | UNIVERSAL AMERICAN MCR-ALL OTHER PLANS | $215.88 | $1,675.29 | $1,172.70 | 2025-12-20 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | COVENTRY FIRST HLTH MCR ADV | COVENTRY FIRST HLTH MCR ADV | $215.88 | $1,675.29 | $1,172.70 | 2025-12-20 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | CARE IMPROVEMENT PLUS - ALL OTHER PLANS | CARE IMPROVEMENT PLUS - ALL OTHER PLANS | $215.88 | $1,675.29 | $1,172.70 | 2025-12-20 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | MULTIPLAN MCR ADV | MULTIPLAN MCR ADV | $215.88 | $1,675.29 | $1,172.70 | 2025-12-20 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | UNIVERSAL AMERICAN MCR-ALL OTHER PLANS | UNIVERSAL AMERICAN MCR-ALL OTHER PLANS | $215.88 | $1,675.29 | $1,172.70 | 2025-12-20 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | AMERIGROUP MCR ADV-ALL OTHER PLANS | AMERIGROUP MCR ADV-ALL OTHER PLANS | $215.88 | $1,675.29 | $1,172.70 | 2025-12-20 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | CARE IMPROVEMENT PLUS MCR | CARE IMPROVEMENT PLUS MCR | $218.04 | $1,675.29 | $1,172.70 | 2025-12-20 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | CARE IMPROVEMENT PLUS MCR | CARE IMPROVEMENT PLUS MCR | $218.04 | $1,675.29 | $1,172.70 | 2025-12-20 | MRF ↗ |
| BOULDER COMMUNITY HEALTH OutpatientFacility | Rocky Mountain Health Maintenance Organization | Managed Medicaid | $219.35 | — | — | 2025-12-23 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | UNIVERSAL AMERICAN SNP | UNIVERSAL AMERICAN SNP | $226.67 | $1,675.29 | $1,172.70 | 2025-12-20 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | UNIVERSAL AMERICAN SNP | UNIVERSAL AMERICAN SNP | $226.67 | $1,675.29 | $1,172.70 | 2025-12-20 | MRF ↗ |
| GRAHAM REGIONAL MEDICAL CENTER Outpatient | Superior HealthPlan | Commercial | $229.00 | $956.00 | $956.00 | 2025-07-03 | MRF ↗ |
| GRAHAM REGIONAL MEDICAL CENTER Outpatient | Amerigroup | Children's Health Insurance Program | $229.00 | $956.00 | $956.00 | 2025-07-03 | MRF ↗ |
| GRAHAM REGIONAL MEDICAL CENTER Outpatient | ChoiceCare Network | Commercial | $229.00 | $956.00 | $956.00 | 2025-07-03 | MRF ↗ |
| GRAHAM REGIONAL MEDICAL CENTER Outpatient | Amerigroup | Medicare Advantage | $229.00 | $956.00 | $956.00 | 2025-07-03 | MRF ↗ |
| GRAHAM REGIONAL MEDICAL CENTER Outpatient | Curative | Commercial | $250.00 | $956.00 | $956.00 | 2025-07-03 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | CIGNA-ALL PLANS | CIGNA-ALL PLANS | $257.40 | $572.00 | $429.00 | 2026-01-16 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | SUPERIOR HP AMBETTER | SUPERIOR HP AMBETTER | $259.06 | $1,675.29 | $1,172.70 | 2025-12-20 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | SUPERIOR HP AMBETTER | SUPERIOR HP AMBETTER | $259.06 | $1,675.29 | $1,172.70 | 2025-12-20 | MRF ↗ |
| CHI HEALTH ST. MARYS Outpatient | Amerigroup | Medicaid|All Plans | $259.40 | $1,211.00 | $1,005.13 | 2026-02-28 | MRF ↗ |
| CHI HEALTH SCHUYLER Outpatient | Amerigroup | Medicaid|All Plans | $259.40 | $1,211.00 | $1,029.35 | 2026-02-28 | MRF ↗ |
| CHI HEALTH ST. MARYS Outpatient | Amerigroup | Medicaid|All Plans | $259.40 | $1,211.00 | $1,005.13 | 2026-02-28 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | PACE | Senior Care Partners | $261.73 | $1,102.00 | $881.60 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | PACE | Senior Care Partners | $261.73 | $1,102.00 | $881.60 | 2026-02-01 | MRF ↗ |
| CHI HEALTH SCHUYLER Outpatient | IAMolina | Medicaid|All Plans | $264.49 | $1,211.00 | $1,029.35 | 2026-02-28 | MRF ↗ |
| CHI HEALTH ST. MARYS Outpatient | IAMolina | Medicaid|All Plans | $264.49 | $1,211.00 | $1,005.13 | 2026-02-28 | MRF ↗ |
| CHI HEALTH ST. MARYS Outpatient | IAMolina | Medicaid|All Plans | $264.49 | $1,211.00 | $1,005.13 | 2026-02-28 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | BCN | Medicare Advantage | $275.50 | $1,102.00 | $881.60 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | BCBS | MAPPO | $275.50 | $1,102.00 | $881.60 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | UHC | Medicare Advantage | $275.50 | $1,102.00 | $881.60 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | VA | VA | $275.50 | $1,102.00 | $881.60 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | BCN | Medicare Advantage | $275.50 | $1,102.00 | $881.60 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | PACE | SWMI | $275.50 | $1,102.00 | $881.60 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | Health Alliance Plan | Medicare Advantage | $275.50 | $1,102.00 | $881.60 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | UHC | Exchange | $275.50 | $1,102.00 | $881.60 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | PHP | Medicare Advantage | $275.50 | $1,102.00 | $881.60 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | VA | VA | $275.50 | $1,102.00 | $881.60 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | BCBS | MAPPO | $275.50 | $1,102.00 | $881.60 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | Railroad Medicare | Medicare | $275.50 | $1,102.00 | $881.60 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | UHC | Dual Complete DSNP | $275.50 | $1,102.00 | $881.60 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | UHC | Medicare Advantage | $275.50 | $1,102.00 | $881.60 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | PHP | Medicare Advantage | $275.50 | $1,102.00 | $881.60 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | UHC | Exchange | $275.50 | $1,102.00 | $881.60 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | PACE | SWMI | $275.50 | $1,102.00 | $881.60 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | Health Alliance Plan | Medicare Advantage | $275.50 | $1,102.00 | $881.60 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | Railroad Medicare | Medicare | $275.50 | $1,102.00 | $881.60 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | UHC | Dual Complete DSNP | $275.50 | $1,102.00 | $881.60 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | Priority Health | Medicare | $278.25 | $1,102.00 | $881.60 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | Priority Health | Medicare | $278.25 | $1,102.00 | $881.60 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | Aetna | Medicare | $286.52 | $1,102.00 | $881.60 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | Aetna | Medicare | $286.52 | $1,102.00 | $881.60 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | Meridian | Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage | $289.27 | $1,102.00 | $881.60 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | Meridian | Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage | $289.27 | $1,102.00 | $881.60 | 2026-02-01 | MRF ↗ |
| GRAHAM REGIONAL MEDICAL CENTER Outpatient | Wellpoint | Commercial | $310.00 | $956.00 | $956.00 | 2025-07-03 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | MI Amish Medical Board | Commercial | $316.82 | $1,102.00 | $881.60 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | MI Amish Medical Board | Commercial | $316.82 | $1,102.00 | $881.60 | 2026-02-01 | MRF ↗ |
| MONTEFIORE MEDICAL CENTER Both | MVP | Medicaid/Essentials | $339.93 | $5,025.00 | $3,286.35 | 2026-04-01 | MRF ↗ |
| MONTEFIORE MEDICAL CENTER Both | MVP | Medicaid/Essentials Midlevels | $339.93 | $5,025.00 | $3,286.35 | 2026-04-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | Amish Plain Church Group | Commercial | $344.38 | $1,102.00 | $881.60 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | Allen County Amish Medical Aid | Commercial | $344.38 | $1,102.00 | $881.60 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | Allen County Amish Medical Aid | Commercial | $344.38 | $1,102.00 | $881.60 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | Amish Plain Church Group | Commercial | $344.38 | $1,102.00 | $881.60 | 2026-02-01 | MRF ↗ |
| KAHUKU MEDICAL CENTER Outpatient | HMSA | Mcd_ABD | $350.60 | — | — | 2024-06-28 | MRF ↗ |
| DELTA MEMORIAL HOSPITAL Both | United Healthcare | Medicare Advantage | — | $1,636.59 | $1,309.27 | 2026-03-31 | MRF ↗ |
| DELTA MEMORIAL HOSPITAL Both | Summit Administration Services, Inc | Default | $363.00 | $1,636.59 | $1,309.27 | 2026-03-31 | MRF ↗ |
| DELTA MEMORIAL HOSPITAL Both | United Healthcare | Medicare Advantage | — | $1,636.59 | $1,309.27 | 2026-03-31 | MRF ↗ |
| DELTA MEMORIAL HOSPITAL Both | Summit Administration Services, Inc | Default | $363.00 | $1,636.59 | $1,309.27 | 2026-03-31 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | MEDICAID ADVANTAGE | 8723_MEDICAID REPLACEMENT OUTPATIENT 20240401 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | MHS CARE CONNECT | 8877_MHS CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | MHS CARE CONNECT | 8877_MHS CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | MHS CARE CONNECT | 8257_MHS CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | 9365_MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | MHS CARE CONNECT | 8257_MHS CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | ANTHEM MEDICAID | 7373_ANTHEM MEDICAID REPLACEMENT OUTPATIENT 20230101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | 9365_MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | MHS CARE CONNECT | 8257_MHS CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | MDWISE HOOSIER ALLIANCE MEDICAID | 9347_MDWISE MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | MEDICAID ADVANTAGE | 8723_MEDICAID REPLACEMENT OUTPATIENT 20240401 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | 9365_MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM CARE CONNECT | 8879_ANTHEM CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | MDWISE HOOSIER ALLIANCE MEDICAID | 8256_MDWISE MEDICAID REPLACEMENT OUTPATIENT 20240101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | MDWISE HOOSIER ALLIANCE MEDICAID | 8256_MDWISE MEDICAID REPLACEMENT OUTPATIENT 20240101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM CARE CONNECT | 8879_ANTHEM CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | ANTHEM MEDICAID | 7373_ANTHEM MEDICAID REPLACEMENT OUTPATIENT 20230101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | MEDICAID ADVANTAGE | 8723_MEDICAID REPLACEMENT OUTPATIENT 20240401 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM MEDICAID | 7373_ANTHEM MEDICAID REPLACEMENT OUTPATIENT 20230101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | MDWISE HOOSIER ALLIANCE MEDICAID | 8256_MDWISE MEDICAID REPLACEMENT OUTPATIENT 20240101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | MDWISE HOOSIER ALLIANCE MEDICAID | 9347_MDWISE MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | ANTHEM MEDICAID | 7373_ANTHEM MEDICAID REPLACEMENT OUTPATIENT 20230101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | MHS CARE CONNECT | 8257_MHS CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | MDWISE HOOSIER ALLIANCE MEDICAID | 9347_MDWISE MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | MEDICAID ADVANTAGE | 8723_MEDICAID REPLACEMENT OUTPATIENT 20240401 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | ANTHEM CARE CONNECT | 8255_ANTHEM CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | MDWISE HOOSIER ALLIANCE MEDICAID | 8256_MDWISE MEDICAID REPLACEMENT OUTPATIENT 20240101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | ANTHEM MEDICAID | 7373_ANTHEM MEDICAID REPLACEMENT OUTPATIENT 20230101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | ANTHEM CARE CONNECT | 8879_ANTHEM CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | MDWISE HOOSIER ALLIANCE MEDICAID | 8256_MDWISE MEDICAID REPLACEMENT OUTPATIENT 20240101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | ANTHEM CARE CONNECT | 8255_ANTHEM CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | MHS CARE CONNECT | 8877_MHS CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | MHS CARE CONNECT | 8877_MHS CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | MDWISE HOOSIER ALLIANCE MEDICAID | 8256_MDWISE MEDICAID REPLACEMENT OUTPATIENT 20240101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | MHS CARE CONNECT | 8877_MHS CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | 9365_MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | MHS CARE CONNECT | 8257_MHS CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | MEDICAID ADVANTAGE | 8723_MEDICAID REPLACEMENT OUTPATIENT 20240401 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | MHS CARE CONNECT | 8877_MHS CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | MDWISE HOOSIER ALLIANCE MEDICAID | 9347_MDWISE MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | MHS CARE CONNECT | 8877_MHS CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | ANTHEM MEDICAID | 7373_ANTHEM MEDICAID REPLACEMENT OUTPATIENT 20230101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | MDWISE HOOSIER ALLIANCE MEDICAID | 9347_MDWISE MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | MHS CARE CONNECT | 8257_MHS CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | MDWISE HOOSIER ALLIANCE MEDICAID | 8256_MDWISE MEDICAID REPLACEMENT OUTPATIENT 20240101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | ANTHEM CARE CONNECT | 8879_ANTHEM CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | MHS CARE CONNECT | 8877_MHS CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | ANTHEM CARE CONNECT | 8879_ANTHEM CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | ANTHEM CARE CONNECT | 8879_ANTHEM CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | ANTHEM CARE CONNECT | 8255_ANTHEM CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | 9365_MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | MEDICAID ADVANTAGE | 8723_MEDICAID REPLACEMENT OUTPATIENT 20240401 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | MHS CARE CONNECT | 8257_MHS CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | ANTHEM CARE CONNECT | 8255_ANTHEM CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | ANTHEM CARE CONNECT | 8879_ANTHEM CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | ANTHEM CARE CONNECT | 8879_ANTHEM CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | MDWISE HOOSIER ALLIANCE MEDICAID | 8256_MDWISE MEDICAID REPLACEMENT OUTPATIENT 20240101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | MDWISE HOOSIER ALLIANCE MEDICAID | 9347_MDWISE MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM MEDICAID | 7373_ANTHEM MEDICAID REPLACEMENT OUTPATIENT 20230101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | MEDICAID ADVANTAGE | 8723_MEDICAID REPLACEMENT OUTPATIENT 20240401 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | MHS CARE CONNECT | 8877_MHS CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | MEDICAID ADVANTAGE | 8723_MEDICAID REPLACEMENT OUTPATIENT 20240401 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | 9365_MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | MHS CARE CONNECT | 8257_MHS CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | MHS CARE CONNECT | 8257_MHS CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | ANTHEM CARE CONNECT | 8879_ANTHEM CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | MEDICAID ADVANTAGE | 8723_MEDICAID REPLACEMENT OUTPATIENT 20240401 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | MHS CARE CONNECT | 8877_MHS CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | MHS CARE CONNECT | 8257_MHS CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | ANTHEM MEDICAID | 7373_ANTHEM MEDICAID REPLACEMENT OUTPATIENT 20230101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | MHS CARE CONNECT | 8877_MHS CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM CARE CONNECT | 8255_ANTHEM CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | MDWISE HOOSIER ALLIANCE MEDICAID | 9347_MDWISE MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | MDWISE HOOSIER ALLIANCE MEDICAID | 9347_MDWISE MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | ANTHEM CARE CONNECT | 8879_ANTHEM CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | 9365_MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | MDWISE HOOSIER ALLIANCE MEDICAID | 8256_MDWISE MEDICAID REPLACEMENT OUTPATIENT 20240101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | ANTHEM CARE CONNECT | 8879_ANTHEM CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | ANTHEM MEDICAID | 7373_ANTHEM MEDICAID REPLACEMENT OUTPATIENT 20230101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | MEDICAID ADVANTAGE | 8723_MEDICAID REPLACEMENT OUTPATIENT 20240401 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | MDWISE HOOSIER ALLIANCE MEDICAID | 8256_MDWISE MEDICAID REPLACEMENT OUTPATIENT 20240101 | $391.41 | — | — | 2026-01-01 | MRF ↗ |
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