220097 — Leuprolide Acetate 6 Month 45mg
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). LEUPROLIDE ACETATE 6 MONTH 45MG (CDM 220097) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/220097?code_type=CDM
MLA (9th ed.)
“LEUPROLIDE ACETATE 6 MONTH 45MG (CDM 220097) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/220097?code_type=CDM. Accessed .
Chicago (notes-bibliography)
“LEUPROLIDE ACETATE 6 MONTH 45MG (CDM 220097) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/220097?code_type=CDM.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $139–$14,426 (25th–75th percentile) across 6 hospitals · 56 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CDM 220097 — 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 |
|---|---|---|---|---|---|---|---|
| ASCENSION GENESYS HOSPITAL Outpatient | MCLAREN HMO MEDICARE | 565_MACLAREN HELATH PLAN 20210601 | $1.17 | $3.89 | $1.63 | 2026-01-01 | MRF ↗ |
| ASCENSION PROVIDENCE HOSPITAL, SOUTHFIELD AND NOVI Outpatient | MCLAREN HMO MEDICARE | 565_MACLAREN HELATH PLAN 20210601 | $1.17 | $3.89 | $1.63 | 2026-01-01 | MRF ↗ |
| ASCENSION GENESYS HOSPITAL Outpatient | SMART HEALTH | 597_SMARTHEALTH 20210201 | $1.32 | $3.89 | $1.63 | 2026-01-01 | MRF ↗ |
| ASCENSION PROVIDENCE HOSPITAL, SOUTHFIELD AND NOVI Outpatient | SMART HEALTH | 597_SMARTHEALTH 20210201 | $1.32 | $3.89 | $1.63 | 2026-01-01 | MRF ↗ |
| ASCENSION PROVIDENCE HOSPITAL, SOUTHFIELD AND NOVI Outpatient | BCCCP | 556_BCCCP 20210201 | $3.89 | $3.89 | $1.63 | 2026-01-01 | MRF ↗ |
| ASCENSION GENESYS HOSPITAL Both | CDM DEFAULT - NON-NEGOTIATED RATE | CDM DEFAULT - NON-NEGOTIATED RATE | $3.89 | $3.89 | $1.63 | 2026-01-01 | MRF ↗ |
| ASCENSION GENESYS HOSPITAL Outpatient | BCCCP | 556_BCCCP 20210201 | $3.89 | $3.89 | $1.63 | 2026-01-01 | MRF ↗ |
| ASCENSION PROVIDENCE HOSPITAL, SOUTHFIELD AND NOVI Both | CDM DEFAULT - NON-NEGOTIATED RATE | CDM DEFAULT - NON-NEGOTIATED RATE | $3.89 | $3.89 | $1.63 | 2026-01-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Superior Health Plan | MCDSTAR | $32.90 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Superior Health Plan | CHIP | $32.90 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Superior Health Plan | STARKids | $32.90 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Superior Health Plan | STARPLUS | $32.90 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Superior Health Plan | STARHealth | $32.90 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Cigna | IFP | $63.45 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Cigna | QHP | $65.80 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Aetna | QHPHIX | $76.61 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | United | OptionsPPO | $88.36 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Imperial Insurance Company | MCR | $89.30 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Superior | EPO | $94.00 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Superior | HMO | $94.00 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Superior | ValueHMO | $94.00 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Oscar | HIX | $97.76 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Unicare | CHIP | $103.40 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Aetna | NewBusiness | $111.86 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Healthcare Highways | NarrowNetwork | $115.15 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | BCBS | BlueAdvantageHMO | $116.09 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | BCBS | MyBlueHealth | $116.09 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Molina Healthcare | HIX | $117.50 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Aetna | Meritain | $120.32 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Aetna | COMM | $120.32 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Evry Health | COMM | $121.26 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Cigna | LocalPlus | $124.08 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Cigna | NewBusiness | $124.08 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | BCBS | BluePremier | $137.24 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Cigna | NetworkBenefit | $138.65 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Cigna | OpenAccessPlus | $138.65 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Cigna | HMO | $138.65 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Aetna | OON | $141.00 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Humana | COMM | $145.65 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | BCBS | BlueEssentialsAccess | $149.93 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | BCBS | BlueEssentials | $149.93 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | BCBS | EPOSOA | $157.45 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Healthcare Highways | CityofPlano | $158.86 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | BCBS | PPO | $164.50 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Cigna | AllOther | $175.31 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Curative Administrators | COMM | $188.00 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | BCBS | Traditional | $208.68 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | City of McKinney | COMM | $211.50 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Fidelis SecureCare | MGMCR | $211.50 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | National ChoiceCare | WCOMP | $235.00 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Emerging Therapy Solutions | MGMCR | $235.00 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Aetna | ASA | $247.69 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Cigna Lifesource | COMM | $249.10 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Physicians Coop of TX | MGMCR | $258.50 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Rockport Health Group | WORKERSCOMP | $258.50 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Aetna | WCOMP | $258.50 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | PC Texas Partners | WCOMP | $258.50 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Averde Health, Inc | PPO | $272.60 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Aetna Coventry First Health | EXCLUSIVE | $276.83 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Aetna Coventry First Health | NONEXCLUSIVE | $276.83 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Mega Life | MGMCRPPO | $329.00 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Coastal Comp Health Networks | WCOMP | $329.00 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Multiplan PHCS | PrimaryNetwork | $329.00 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | HealthSmart Preferred Care | PPO | $333.70 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Emerging Therapy Solutions | Commercial | $338.40 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | LEWISVILLE ISD/DLS CONSULTING | COMMPPO | $352.50 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Molina Healthcare | HIX | $352.50 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | USC Health Services | COMM | $376.00 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | USA Managed Care | COMM | $376.00 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | TCU ATHLETICS | COMM | $376.00 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Galaxy Health Network | PPO | $399.50 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Optum Transplant | COMM | $404.20 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Unicare | MCD | $470.00 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | National Healthcare Solutions | COMM | $470.00 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Independent Medical Systems | COMM | $470.00 | $470.00 | $470.00 | 2026-03-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | US HEALTH AND LIFE | 1991_BOMC, BOLE, BPHC US HEALTH AND LIFE 20200101 | $5,228.77 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | US HEALTH AND LIFE | 1991_BOMC, BOLE, BPHC US HEALTH AND LIFE 20200101 | $5,228.77 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | SMARTHEALTH | 3501_SMARTHEALTH 20230101 | $5,602.25 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | SMARTHEALTH | 3501_SMARTHEALTH 20230101 | $5,602.25 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| UNION COUNTY GENERAL HOSPITAL Outpatient | Aetna | Commercial | $6,264.00 | $6,960.00 | $4,872.00 | 2025-06-17 | MRF ↗ |
| UNION COUNTY GENERAL HOSPITAL Outpatient | Blue Cross and Blue Shield of New Mexico | Commercial | $6,264.00 | $6,960.00 | $4,872.00 | 2025-06-17 | MRF ↗ |
| UNION COUNTY GENERAL HOSPITAL Outpatient | Humana Inc. | Commercial | $6,264.00 | $6,960.00 | $4,872.00 | 2025-06-17 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | PRIORITY HEALTH APPLE | 2606_BOMC, BPHC PRIORITY HEALTH APPLE 20200101 | $8,216.64 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | PRIORITY HEALTH APPLE | 2606_BOMC, BPHC PRIORITY HEALTH APPLE 20200101 | $8,216.64 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | COFINITY ADVANTAGE | 2002_COFINITY ADVANTAGE 20200101 | $9,150.35 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | COFINITY ADVANTAGE | 2002_COFINITY ADVANTAGE 20200101 | $9,150.35 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | ALLEGAN MEDICARE | 3127_BOAH MEDICARE OUTPATIENT 20231001 | $9,897.32 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | AUTO MVA | 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215 | $9,897.32 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ALLEGAN MOLINA MEDICARE | 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215 | $9,897.32 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | ALLEGAN MOLINA MEDICARE | 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215 | $9,897.32 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ALLEGAN HUMANA MCR | 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001 | $9,897.32 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | AUTO MVA | 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215 | $9,897.32 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ALLEGAN MEDICARE | 3127_BOAH MEDICARE OUTPATIENT 20231001 | $9,897.32 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | ALLEGAN HUMANA MCR | 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001 | $9,897.32 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | PRIORITY HEALTH HMO/PPO | 2404_BOGI BOSU PRIORITY HEALTH 20200401 | $11,204.51 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | MAGELLAN | 2050_BOMC, BPHC MAGELLAN 20210201 | $11,204.51 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | PRIORITY HEALTH HMO/PPO | 2404_BOGI BOSU PRIORITY HEALTH 20200401 | $11,204.51 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | CIGNA | 2827_BOGI BOSU CIGNA 20210912 | $11,204.51 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | MAGELLAN | 2050_BOMC, BPHC MAGELLAN 20210201 | $11,204.51 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | CIGNA | 2827_BOGI BOSU CIGNA 20210912 | $11,204.51 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | COFINITY | 1993_BOMC, BPHC COFINITY PPOM 20200101 | $12,885.18 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | COFINITY | 1993_BOMC, BPHC COFINITY PPOM 20200101 | $12,885.18 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | PHCS | 1995_BOMC, BPHC PHCS 20200101 | $14,005.64 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | PHCS | 1971_BOGI, BOSU PHCS 20200101 | $14,005.64 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | PHCS | 1971_BOGI, BOSU PHCS 20200101 | $14,005.64 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | PHCS | 1995_BOMC, BPHC PHCS 20200101 | $14,005.64 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ALLEGAN UHC | 3184_BOAH UNITED HEALTH CARE 20240701 | $14,379.12 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | ALLEGAN UHC | 3184_BOAH UNITED HEALTH CARE 20240701 | $14,379.12 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | BCBS ALL OTHER | 3496_BOAH BLUE CROSS TRADITIONAL 20240701 | $14,565.86 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | CIGNA ALLEGAN | 3180_BOAH CIGNA 20230701 | $14,565.86 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | BC OF MICH TRAD | 3494_BOAH BLUE CROSS TRUST 20240701 | $14,565.86 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | BCBS ALL OTHER | 3496_BOAH BLUE CROSS TRADITIONAL 20240701 | $14,565.86 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | BC OF MICH TRAD | 3494_BOAH BLUE CROSS TRUST 20240701 | $14,565.86 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | CIGNA ALLEGAN | 3180_BOAH CIGNA 20230701 | $14,565.86 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | ALLEGAN PRIORITY HEALTH HMO AND PPO | 3126_BOAH PRIORITY HEALTH HMO AND PPO 20100101 | $14,752.60 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ALLEGAN PRIORITY HEALTH HMO AND PPO | 3126_BOAH PRIORITY HEALTH HMO AND PPO 20100101 | $14,752.60 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ASR CORP | 2588_BOMC, BPHC, BOLE ASR CORP 20200101 | $14,939.34 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | COFINITY | 1969_BOGI, BOSU COFINITY 20200101 | $14,939.34 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | ASR CORP | 2588_BOMC, BPHC, BOLE ASR CORP 20200101 | $14,939.34 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | FIRST HEALTH | 1994_BOMC, BPHC, BOSU, BOGI FIRST HEALTH 20200101 | $14,939.34 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | COFINITY | 1969_BOGI, BOSU COFINITY 20200101 | $14,939.34 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | FIRST HEALTH | 1994_BOMC, BPHC, BOSU, BOGI FIRST HEALTH 20200101 | $14,939.34 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | HEALTHSCOPE | 1989_BOMC, BOLE, BPHC HEALTHSCOPE 20200101 | $15,312.83 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | HEALTHSCOPE | 1989_BOMC, BOLE, BPHC HEALTHSCOPE 20200101 | $15,312.83 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | PREFERRED CHOICES | 2605_PREFERRED CHOICES 20200101 | $15,873.05 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | DIRECT CARE AMERICA | 2581_DIRECT CARE AMERICA 20200101 | $15,873.05 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | PREFERRED CHOICES | 2605_PREFERRED CHOICES 20200101 | $15,873.05 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | DIRECT CARE AMERICA | 2581_DIRECT CARE AMERICA 20200101 | $15,873.05 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | MULTIPLAN | 2393_BOMC BPHC MULTIPLAN 20190101 | $16,433.28 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | MULTIPLAN | 2393_BOMC BPHC MULTIPLAN 20190101 | $16,433.28 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | HUMANA | 2623_BOMC, BOLE, BPHC HUMANA 20210401 | $16,806.76 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | COFINITY | 1975_BOLE COFINITY 20200101 | $16,806.76 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | HUMANA | 2623_BOMC, BOLE, BPHC HUMANA 20210401 | $16,806.76 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | COFINITY | 1975_BOLE COFINITY 20200101 | $16,806.76 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | CHA | 2589_BOMC, BPHC, BOLE CHA 20200101 | $17,180.25 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | CHA | 2589_BOMC, BPHC, BOLE CHA 20200101 | $17,180.25 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ASR CORP | 2602_BOSU, BOGI ASR CORP 20200101 | $17,740.47 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ASR 2 | 1970_BOGI, BOSU HEALTHSCOPE 98R 20200101 | $17,740.47 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | HEALTHSCOPE | 2601_BOSU, BOGI HEALTHSCOPE 20200101 | $17,740.47 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | ASR CORP | 2602_BOSU, BOGI ASR CORP 20200101 | $17,740.47 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | HEALTHSCOPE | 2601_BOSU, BOGI HEALTHSCOPE 20200101 | $17,740.47 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | ASR 2 | 1970_BOGI, BOSU HEALTHSCOPE 98R 20200101 | $17,740.47 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Both | CDM DEFAULT - NON-NEGOTIATED RATE | CDM DEFAULT - NON-NEGOTIATED RATE | $18,674.18 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Both | CDM DEFAULT - NON-NEGOTIATED RATE | CDM DEFAULT - NON-NEGOTIATED RATE | $18,674.18 | $18,674.18 | $9,150.35 | 2026-01-01 | MRF ↗ |