21931 — Exc Back Les Sc 3 Cm/>
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). EXC BACK LES SC 3 CM/> (CPT 21931) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/21931?code_type=CPT
MLA (9th ed.)
“EXC BACK LES SC 3 CM/> (CPT 21931) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/21931?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“EXC BACK LES SC 3 CM/> (CPT 21931) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/21931?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $1,348–$3,748 (25th–75th percentile) across 2,290 hospitals · 6,524 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 21931 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.
Estimated complete episode
What the whole episode might cost
Your hospital facility price plus the separately-billed professional fees a complete episode adds. The facility figure is an actual negotiated rate from our data; the surgeon and anesthesia fees are estimated from the Medicare fee schedule scaled to commercial rates — not facility-specific quotes.
What hospitals actually negotiate
Measured
$1,348
$2,063 typical
$3,748
The middle 50% of negotiated facility rates for this procedure, measured across 2,290 hospitals. The surgeon and anesthesia fees are modeled estimates added on top.
What you’ll likely be billed
| Hospital facility Actual median across hospitals The hospital’s negotiated facility rate — from our MRF data. | $2,063 |
| Surgeon (professional fee) Estimate national typical Medicare $454 × 1.22 commercial. | $553 |
| Anesthesia Estimate national typical Generic anesthesia (~90 min typical, median CMS base units). Medicare $225 × 3.14 commercial. Approximate — no procedure-specific anesthesia mapping for this code. | $708 |
| Likely subtotal | $3,324 |
Surgical episode (typical)
~$3,324
Your recovery plan — adjust to what your doctor told you
After your procedure, recovery care is billed separately. We pre-fill the typical plan; change it to your situation.
Recovery cost modeled
~$3,785
With your recovery plan (typical)
~$7,109
- The anesthesia component is a generic, approximate estimate — no procedure-specific anesthesia mapping exists for this code, so a typical anesthesia for this procedure type is shown.
How each figure is sourced
- Hospital facility (actual)
- source: Hospital MRF (45 CFR 180)
- Surgeon (professional fee) (estimate)
- rvu_version: RVU26A (updated 2025-12-29) · gpci: National (unadjusted, GPCI = 1.000) · cf_rule: CMS-1832-F ($33.40) · multiplier_source: HCCI 2017 national
- Anesthesia (estimate)
- base_units_version: CY2022 file (base units unchanged for CY2026 per CMS) · anesthesia_cf: $20.49754 (National) · cf_rule: CMS-1832-F · multiplier_source: AJMC/Duffy 2016-2017 (PMID 34156223) national · basis: generic surgical anesthesia — 5 base units (typical CMS value) × ~90 min; approximate, NOT a procedure-specific crosswalk
Estimates use CMS Medicare Physician Fee Schedule reference data (RVU × GPCI × conversion factor; anesthesia base+time × CF) scaled by a sourced commercial multiplier, weighted by how often each component is billed. See the methodology. Your real total appears on your insurer’s Explanation of Benefits (EOB).
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 |
|---|---|---|---|---|---|---|---|
| CHI Memorial Hospital - Hixson Outpatient | Alliant Health | Commercial|All Plans | $0.65 | — | — | 2026-02-28 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | IOWA DEPT OF PUBLIC HEALTH | CARE FOR YOURSELF | $0.96 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | IOWA DEPT OF PUBLIC HEALTH | CARE FOR YOURSELF | $0.96 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| UMASS MEMORIAL HEALTHALLIANCE HOSPITALS Outpatient | WELLSENSE MEDICAID [10901] | All WELLSENSE MEDICAID (FORMERLY BMC) HA [43] Plans | $2.89 | $13,387.91 | $13,387.91 | 2026-03-26 | MRF ↗ |
| CARROLL COUNTY MEMORIAL HOSPITAL Both | Medicare A Ky J15 | Default | $2.94 | $10.00 | $6.00 | 2026-05-22 | MRF ↗ |
| CARROLL COUNTY MEMORIAL HOSPITAL Both | Humana Advantage Care Plans Med Advantage | Medicare Advantage | $2.94 | $10.00 | $6.00 | 2026-05-22 | MRF ↗ |
| CARROLL COUNTY MEMORIAL HOSPITAL Both | Wellcare Health Plan Inc Mcr Adv | Medicare Advantage | $2.94 | $10.00 | $6.00 | 2026-05-22 | MRF ↗ |
| CARROLL COUNTY MEMORIAL HOSPITAL Both | Wellcare Health Plan Mcd Rep | Medicaid Replacement | $3.20 | $10.00 | $6.00 | 2026-05-22 | MRF ↗ |
| CARROLL COUNTY MEMORIAL HOSPITAL Both | Medicaid Kentucky | Default | $3.20 | $10.00 | $6.00 | 2026-05-22 | MRF ↗ |
| CARROLL COUNTY MEMORIAL HOSPITAL Both | Blue Cross Blue Shield Of Ky Anthem | Medicare Advantage | $3.20 | $10.00 | $6.00 | 2026-05-22 | MRF ↗ |
| CARROLL COUNTY MEMORIAL HOSPITAL Both | Blue Cross Blue Shield Of Ky Anthem | Medicaid Replacement | $3.20 | $10.00 | $6.00 | 2026-05-22 | MRF ↗ |
| CARROLL COUNTY MEMORIAL HOSPITAL Both | Uhc Group Medicare Advantage | Medicare Advantage | $3.20 | $10.00 | $6.00 | 2026-05-22 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - SD (WELLMARK) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE SHIELD - NY HIGHMARK NORTHEASTERN | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MI | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - AL | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - CA (ANTHEM) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MS | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - AZ | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE SHIELD - PA (HIGHMARK) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - AK (PREMERA) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - CT (ANTHEM) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - ID | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - WV (HIGHMARK) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MO (ANTHEM) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NJ (HORIZON) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE SHIELD - ID (REGENCE) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - AR | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - GA (ANTHEM) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE SHIELD - NY HIGHMARK WESTERN | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - SC | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NV (ANTHEM) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - ND | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - AL | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NC | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE SHIELD - NY HIGHMARK WESTERN | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - IN (ANTHEM) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - IN (ANTHEM) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - FEDERAL | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MO (ANTHEM) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - IL | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - WY | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - TN | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE DISTINCTION TRANSPLANT | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - ME (ANTHEM) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - IL ALTERNATE | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - IA (WELLMARK) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - WI (ANTHEM) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MA | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - KY (ANTHEM) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - AK (PREMERA) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - CO (ANTHEM) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE DISTINCTION TRANSPLANT | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - DE (HIGHMARK) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NE | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - ID | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - WV (HIGHMARK) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - TN | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - PA (INDEPENDENCE) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - OK | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NC | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE SHIELD - CA | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - SD (WELLMARK) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - RI | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MS | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - AR | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - ME (ANTHEM) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - KY (ANTHEM) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MN | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - PA (INDEPENDENCE) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - CO (ANTHEM) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - CA (ANTHEM) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - OR (REGENCE) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - WA (PREMERA) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NH (ANTHEM) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NH (ANTHEM) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - LA | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - TX | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NM | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - KS | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - OH (ANTHEM) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - PA (CAPITAL) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NJ (HORIZON) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - IA (WELLMARK) | WELLMARK HMO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - ND | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - OK | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - RI | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - FL | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE SHIELD - CA | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NY (EXCELLUS) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - WA (PREMERA) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NY (ANTHEM) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - VA (CAREFIRST) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - CT (ANTHEM) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - WY | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - VA (ANTHEM) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - DC (CAREFIRST) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - VA (CAREFIRST) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - UT (REGENCE) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - VT | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MD (CAREFIRST) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - FL | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BCBS GENERIC | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - DE (HIGHMARK) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - LA | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - OH (ANTHEM) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MT | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MI | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BCBS GENERIC | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE SHIELD - NY HIGHMARK NORTHEASTERN | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MD (CAREFIRST) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - AZ | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - HI | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - DC (CAREFIRST) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - HI | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CARE NETWORK | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MA | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NY (EXCELLUS) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE SHIELD - ID (REGENCE) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE SHIELD - WA (REGENCE) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - GA (ANTHEM) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - FEDERAL | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CARE NETWORK | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - TX | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - KS | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - VT | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - UT (REGENCE) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - PA (CAPITAL) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NY (ANTHEM) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - WI (ANTHEM) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NM | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MT | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - IL ALTERNATE | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - VA (ANTHEM) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - IL | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MN | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - IA (WELLMARK) | WELLMARK HMO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - OR (REGENCE) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - IA (WELLMARK) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE SHIELD - PA (HIGHMARK) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NE | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE SHIELD - WA (REGENCE) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NV (ANTHEM) | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| MERCYONE CENTERVILLE MEDICAL CENTER OutpatientFacility | BLUE CROSS - SC | WELLMARK PPO | $3.36 | — | $11,469.13 | 2026-03-31 | MRF ↗ |
| UMASS MEMORIAL HEALTHALLIANCE HOSPITALS Outpatient | WELLSENSE MEDICAID [10901] | All WELLSENSE SPECIAL KIDS (FORMERLY BMC) HA [257] Plans | $3.61 | $13,387.91 | $13,387.91 | 2026-03-26 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Outpatient | AMBETTER COMM - ALL PLANS | AMBETTER COMM - ALL PLANS | $3.63 | $349.50 | $349.50 | 2026-04-24 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $4.94 | $1,334.00 | $1,267.30 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | UnitedHealth Group of WI | Medicare Advantage | $4.94 | $1,334.00 | $1,267.30 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $4.94 | $1,334.00 | $1,267.30 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $5.07 | $1,334.00 | $1,267.30 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $5.20 | $1,334.00 | $1,267.30 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Point Comfort Underwriters | Organizational | $5.34 | $1,334.00 | $1,267.30 | 2026-02-20 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $5.85 | $2,240.00 | $1,680.00 | 2025-03-07 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $6.40 | $1,334.00 | $1,267.30 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $6.40 | $1,334.00 | $1,267.30 | 2026-02-20 | MRF ↗ |
| UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient | GRANTS [20507] | All TB GETCHELL [226] Plans | $6.52 | $12,672.60 | $12,672.60 | 2025-12-08 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Point Comfort Underwriters | Organizational | $6.54 | $1,334.00 | $1,267.30 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $6.54 | $1,334.00 | $1,267.30 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $6.54 | $1,334.00 | $1,267.30 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $6.54 | $1,334.00 | $1,267.30 | 2026-02-20 | MRF ↗ |
| VALLEY MEDICAL CENTER Outpatient | GREAT WEST [190102] | CIGNA.COMMERCIAL.FACILITY.VMC | $6.56 | $22,155.82 | $15,509.07 | 2026-03-12 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $6.67 | $1,334.00 | $1,267.30 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $6.80 | $1,334.00 | $1,267.30 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $6.94 | $1,334.00 | $1,267.30 | 2026-02-20 | MRF ↗ |
| CARROLL COUNTY MEMORIAL HOSPITAL Both | United Healthcare | Default | $7.00 | $10.00 | $6.00 | 2026-05-22 | MRF ↗ |
| CARROLL COUNTY MEMORIAL HOSPITAL Both | Blue Cross Blue Shield Of Ky Anthem | Default | $7.15 | $10.00 | $6.00 | 2026-05-22 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Point Comfort Underwriters | Organizational | $7.20 | $1,334.00 | $1,267.30 | 2026-02-20 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | WELLSENSE MEDICAID [10901] | All WELLSENSE MEDICAID (FORMERLY BMC) UM [75] Plans | $7.46 | $24,356.35 | $24,356.35 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL HEALTHALLIANCE HOSPITALS Outpatient | MGB MEDICAID [10906] | All MGB (FORMERLY AHP) ACO HA [197] Plans | $7.59 | $16,783.94 | $16,783.94 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL HEALTHALLIANCE HOSPITALS Outpatient | MASSHEALTH [20302] | All MASSHEALTH HA [93] Plans | $7.59 | $16,783.94 | $16,783.94 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL HEALTHALLIANCE HOSPITALS Outpatient | HNE MEDICAID [10905] | All HEALTH NEW ENGLAND/MINUTEMAN MCO HA [223] Plans | $7.59 | $16,783.94 | $16,783.94 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL HEALTHALLIANCE HOSPITALS Outpatient | FALLON MEDICAID [10904] | All FALLON ACO HA [79] Plans | $7.59 | $16,783.94 | $16,783.94 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL HEALTHALLIANCE HOSPITALS Outpatient | INSTITUTION [10406] | All WORCESTER RECOVERY HA [235] Plans | $7.59 | $16,783.94 | $16,783.94 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL HEALTHALLIANCE HOSPITALS Outpatient | FALLON MEDICAID [10904] | All FALLON MCO HA [55] Plans | $7.59 | $16,783.94 | $16,783.94 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient | MASSHEALTH [20302] | All MASSHEALTH MH [90] Plans | $7.59 | $12,672.60 | $12,672.57 | 2025-12-08 | MRF ↗ |
| UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient | INSTITUTION [10406] | All WORCESTER RECOVERY MH [234] Plans | $7.59 | $12,672.60 | $12,672.57 | 2025-12-08 | MRF ↗ |
| UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient | TUFTS MEDICAID [10908] | All TUFTS TOGETHER MH [123] Plans | $7.59 | $12,672.60 | $12,672.57 | 2025-12-08 | MRF ↗ |
| UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient | FALLON MEDICAID [10904] | All FALLON MCO MH [225] Plans | $7.59 | $12,672.60 | $12,672.57 | 2025-12-08 | MRF ↗ |
| UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient | WELLSENSE MEDICAID [10901] | All WELLSENSE MEDICAID (FORMERLY BMC) MH [8] Plans | $7.59 | $12,672.60 | $12,672.57 | 2025-12-08 | MRF ↗ |
| UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient | HNE MEDICAID [10905] | All HEALTH NEW ENGLAND/MINUTEMAN MCO MH [221] Plans | $7.59 | $12,672.60 | $12,672.57 | 2025-12-08 | MRF ↗ |
| UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient | MGB MEDICAID [10906] | All MGB (FORMERLY AHP) ACO MH [202] Plans | $7.59 | $12,672.60 | $12,672.57 | 2025-12-08 | MRF ↗ |
| UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient | FALLON MEDICAID [10904] | All FALLON ACO MH [80] Plans | $7.59 | $12,672.60 | $12,672.57 | 2025-12-08 | MRF ↗ |
| CARROLL COUNTY MEMORIAL HOSPITAL Both | Humana | Default | $8.35 | $10.00 | $6.00 | 2026-05-22 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | WELLSENSE MEDICAID [10901] | All WELLSENSE SPECIAL KIDS (FORMERLY BMC) UM [255] Plans | $9.33 | $24,356.35 | $24,356.35 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient | WELLSENSE MEDICAID [10901] | All WELLSENSE SPECIAL KIDS (FORMERLY BMC) MH [256] Plans | $9.49 | $12,672.60 | $12,672.57 | 2025-12-08 | MRF ↗ |
| CARROLL COUNTY MEMORIAL HOSPITAL Both | Medicare B Ky J15 | Default | $9.80 | $10.00 | $6.00 | 2026-05-22 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MT | WELLMARK PPO | $10.17 | — | $18,018.03 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MS | WELLMARK PPO | $10.17 | — | $18,018.03 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NM | WELLMARK PPO | $10.17 | — | $18,018.03 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NV (ANTHEM) | WELLMARK PPO | $10.17 | — | $18,018.03 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | WC DOMESTIC | WELLMARK PPO | $10.17 | — | $18,018.03 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - VA (CAREFIRST) | WELLMARK PPO | $10.17 | — | $18,018.03 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - UT (REGENCE) | WELLMARK PPO | $10.17 | — | $18,018.03 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BCN DOMESTIC | WELLMARK PPO | $10.17 | — | $18,018.03 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BCBS GENERIC | WELLMARK PPO | $10.17 | — | $18,018.03 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS DOMESTIC | WELLMARK PPO | $10.17 | — | $18,018.03 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CARE NETWORK | WELLMARK PPO | $10.17 | — | $18,018.03 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - FEDERAL | WELLMARK PPO | $10.17 | — | $18,018.03 | 2026-03-31 | MRF ↗ |
Showing the first 200 rate rows. The CSV export above returns up to 1,000 rows — filter by state to narrow a code with more than that.