220102 — Octreotide Lar Depot Kit 30mg, Per 1mg
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). OCTREOTIDE LAR DEPOT KIT 30MG, PER 1MG (CDM 220102) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/220102?code_type=CDM
MLA (9th ed.)
“OCTREOTIDE LAR DEPOT KIT 30MG, PER 1MG (CDM 220102) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/220102?code_type=CDM. Accessed .
Chicago (notes-bibliography)
“OCTREOTIDE LAR DEPOT KIT 30MG, PER 1MG (CDM 220102) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/220102?code_type=CDM.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $18–$12,118 (25th–75th percentile) across 7 hospitals · 87 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CDM 220102 — 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 |
|---|---|---|---|---|---|---|---|
| NORTH AUSTIN MEDICAL CENTER Outpatient | Superior Health Plan | CHPFC | $1.15 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Superior Health Plan | CHIP | $1.15 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Superior Health Plan | STAR | $1.15 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Superior Health Plan | STARPLUS | $1.15 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Amerigroup | CHIP | $3.22 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Amerigroup | MCD | $3.22 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | BCBS | MyBlueHealth | $3.43 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Superior Health Plan | ValueHMO | $3.91 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Superior Health Plan | AmbetterHMO | $3.91 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Superior Health Plan | AmbetterEPO | $3.91 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | BCBS | BlueAdvantage | $4.03 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Imperial Insurance | MGMCR | $4.37 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Oscar | HMO | $4.42 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Oscar | HIX | $4.42 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Oscar | PPO | $4.92 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Oscar | EPO | $4.92 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Oscar | POS | $4.92 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | MODA | HIX | $5.41 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | United | OptionsPPO | $5.73 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | BCBS | BlueEssentials | $6.28 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | BCBS | BlueEssentialsAccess | $6.28 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Covenant Management Systems | HMO | $6.62 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Healthcare Highways | EPO | $6.69 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | BCBS | Traditional | $6.79 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | BCBS | EPOSOA | $6.81 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Healthcare Highways | PPO | $6.90 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | IMO Med - Select Network | WC | $6.90 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | BCBS | PPO | $7.34 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Sendero | ACHP | $7.36 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Nomi Health | COMMTier1OutofNetwork | $7.36 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Cigna | NewBusinessNetwork | $7.38 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Cigna | HMO | $7.87 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Cigna | OpenAccess | $7.87 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Cigna | OpenAccessPlus | $7.87 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Shared Health | MGMCR | $8.05 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Aetna | QHPExchange(HIX) | $8.21 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | MODA Health | EPO | $8.28 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Evry Health | BroadNetwork | $8.46 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | MODA Health | PPO | $8.51 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Nomi Health | COMMTier1 | $8.51 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Nomi Health | Tier2OutofNetwork | $8.51 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Texas Healthcare Foundation HEB | WC | $8.51 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Texas Healthcare Foundation HEB | COMM | $8.51 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Texas Workforce Commission | WCOMP | $8.97 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Curative Administrators | COMM | $9.20 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Harbor Health Team | COMMPPO | $9.20 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Cigna | PPO | $9.43 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Aetna | NarrowNetwork | $10.33 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | NaphCare | MGMCR | $10.35 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Seven Corners | GVT | $10.35 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | United | GlobalBenefitPlan | $10.35 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Optum Health | COMM | $10.35 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Averde Health | COMM | $10.35 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Aetna | Meritain | $10.93 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Aetna | COMM | $10.93 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Austin FC | WORKERSCOMP | $11.50 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | National ChoiceCare | WC | $11.50 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Comanche County | LOCALGOV | $11.50 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | HealthSmart Preferred Care | Accel | $12.65 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Physicians Cooperative of Texas | WC | $12.65 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Independent Medical Systems | COMM | $12.65 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Aetna | ASA | $12.72 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Aetna | OON | $12.86 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Prime Health | WC | $13.80 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | First Health | PPO | $14.38 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Coastal Comp Health Networks | WORKERSCOMP | $14.95 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | National Health Care | COMM | $14.95 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | First Health | PPO | $15.73 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Texas Municipal League | COMM | $16.10 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | First Health | PPO | $16.33 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | MedCorp Southwest | MCR | $17.25 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | MedCorp Southwest | MCD | $17.25 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Health Services Coalition | COMM | $17.82 | $131.00 | $131.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | HealthSmart Preferred Care | COMM | $18.40 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Rockport Healthcare Group | WORKERSCOMPRockportCommunityNetwork | $18.40 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Imperial NV | MCR | $19.65 | $131.00 | $131.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Medical Control Network Solutions | MedicalControlNetwork | $20.70 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Rockport Healthcare Group | WORKERSCOMPNewtonHealthcareNetwork | $20.70 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Beech Street | COMMPPO | $20.70 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Multiplan | COMMPPO | $20.70 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | BCE Emergis Corporation | COMMPPO | $20.70 | $23.00 | $23.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Aetna | PPO | $26.86 | $131.00 | $131.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Aetna | HMO | $26.86 | $131.00 | $131.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Centene | HIX | $27.51 | $131.00 | $131.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Select Health | HIX | $28.30 | $131.00 | $131.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | United | OptionsPPO | $28.56 | $131.00 | $131.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | CIGNA | OAP | $29.34 | $131.00 | $131.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Select Health | COMM | $30.20 | $131.00 | $131.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Prominence HealthFirst | COMM | $39.30 | $131.00 | $131.00 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Regence Blue Shield | MGMCR | $50.00 | $22,668.61 | $22,668.61 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | CMN Global | COMM | $55.02 | $131.00 | $131.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Hometown Health Providers | HMO/PPO/POS | $65.50 | $131.00 | $131.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Hometown Health Providers | ThirdPartyAdministratior(TPA) | $65.50 | $131.00 | $131.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Evernorth | COMM | $65.50 | $131.00 | $131.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | NV Health & Welfare Trust | COMM | $78.60 | $131.00 | $131.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | MultiPlan | PRIMARY | $82.53 | $131.00 | $131.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | MultiPlan | INTERNATIONAL | $82.53 | $131.00 | $131.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | First Health | COMMPPO | $86.46 | $131.00 | $131.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | MultiPlan | COMPLEMENTARY | $95.63 | $131.00 | $131.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Olympus MedSave USA | COMM | $98.25 | $131.00 | $131.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | MedCare International | COMM | $98.25 | $131.00 | $131.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | First Health | WC | $104.80 | $131.00 | $131.00 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | University of Utah | HMP | — | $20,607.83 | $20,607.83 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | United | OptionsPPO | — | $20,607.83 | $20,607.83 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Molina | HIX | — | $20,607.83 | $20,607.83 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Cigna | PPO | — | $20,607.83 | $20,607.83 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Multiplan | PRIMARY | — | $20,607.83 | $20,607.83 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Multiplan | COMPLEMENTARY | — | $20,607.83 | $20,607.83 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Blue Cross | PPO | — | $20,607.83 | $20,607.83 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Blue Cross | ConnectedCare | — | $20,607.83 | $20,607.83 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Blue Cross | POS | — | $20,607.83 | $20,607.83 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Blue Cross | QEP | — | $20,607.83 | $20,607.83 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Blue Cross | QHP | — | $20,607.83 | $20,607.83 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Blue Cross | TRAD | — | $20,607.83 | $20,607.83 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | University of Utah | PPO | — | $20,607.83 | $20,607.83 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | University of Utah | HIX | — | $20,607.83 | $20,607.83 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Prime Health | WCOMP | — | $20,607.83 | $20,607.83 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Prime Health | GROUPHEALTH | — | $20,607.83 | $20,607.83 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Prime Health | INDIGENTCARE | — | $20,607.83 | $20,607.83 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Aetna | PEAKPERFERENCE | — | $20,607.83 | $20,607.83 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Coventry First Health | WCOMP | — | $20,607.83 | $20,607.83 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | TriWest Healthcare Alliance | Veterans | — | $20,607.83 | $20,607.83 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | GEHA PPO USA | COMM | — | $20,607.83 | $20,607.83 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Intermountain Healthcare | PPO | — | $20,607.83 | $20,607.83 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Intermountain Healthcare | HIX | — | $20,607.83 | $20,607.83 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | DMBA | HMO | — | $20,607.83 | $20,607.83 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | DMBA | PPO | — | $20,607.83 | $20,607.83 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Mountain Health Co-Op | Group | — | $20,607.83 | $20,607.83 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Mountain Health Co-Op | Individual | — | $20,607.83 | $20,607.83 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | EverNorth BH | COMM | — | $20,607.83 | $20,607.83 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Doug Andrus Distributing | COMM | — | $20,607.83 | $20,607.83 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | First Choice Health Of Washington | WCOMP | — | $20,607.83 | $20,607.83 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | First Choice of the Midwest | COMM | — | $20,607.83 | $20,607.83 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Interwest Health | PPO | — | $20,607.83 | $20,607.83 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | PacificSource Health | PPO | — | $20,607.83 | $20,607.83 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | PacificSource Health | CCNNetworks | — | $20,607.83 | $20,607.83 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Select Health Idaho (EIRMC only) | SelectMed | — | $20,607.83 | $20,607.83 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Select Health Idaho (EIRMC only) | HIX | — | $20,607.83 | $20,607.83 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Select Health Idaho (EIRMC only) | PPO | — | $20,607.83 | $20,607.83 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Shashone-Bannock Tribal Health | MCR | — | $20,607.83 | $20,607.83 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Shashone-Bannock Tribal Health | FED | — | $20,607.83 | $20,607.83 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | St. John's Health Network | COMM | — | $20,607.83 | $20,607.83 | 2024-10-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Elevance (Anthem BCBS) | MCR | $131.00 | $131.00 | $131.00 | 2026-03-01 | MRF ↗ |
| ROLLING PLAINS MEMORIAL HOSPITAL Outpatient | Humana (Choice Care) | Commercial | $132.00 | $188.00 | $122.00 | 2025-06-26 | MRF ↗ |
| ROLLING PLAINS MEMORIAL HOSPITAL Outpatient | United Healthcare | Commercial | $142.00 | $188.00 | $122.00 | 2025-06-26 | MRF ↗ |
| ROLLING PLAINS MEMORIAL HOSPITAL Outpatient | Blue Cross and Blue Shield | Traditional | $150.00 | $188.00 | $122.00 | 2025-06-26 | MRF ↗ |
| ROLLING PLAINS MEMORIAL HOSPITAL Outpatient | Blue Cross and Blue Shield | HMO | $150.00 | $188.00 | $122.00 | 2025-06-26 | MRF ↗ |
| ROLLING PLAINS MEMORIAL HOSPITAL Outpatient | Blue Cross and Blue Shield | PPO | $150.00 | $188.00 | $122.00 | 2025-06-26 | MRF ↗ |
| ROLLING PLAINS MEMORIAL HOSPITAL Outpatient | Cigna | Commercial | $152.00 | $188.00 | $122.00 | 2025-06-26 | MRF ↗ |
| ROLLING PLAINS MEMORIAL HOSPITAL Outpatient | Aetna | Commercial | $160.00 | $188.00 | $122.00 | 2025-06-26 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | US HEALTH AND LIFE | 1991_BOMC, BOLE, BPHC US HEALTH AND LIFE 20200101 | $4,350.05 | $15,535.88 | $7,612.58 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | US HEALTH AND LIFE | 1991_BOMC, BOLE, BPHC US HEALTH AND LIFE 20200101 | $4,350.05 | $15,535.88 | $7,612.58 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | US HEALTH AND LIFE | 1991_BOMC, BOLE, BPHC US HEALTH AND LIFE 20200101 | $4,350.05 | $15,535.88 | $7,612.58 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | SMARTHEALTH | 3501_SMARTHEALTH 20230101 | $4,660.76 | $15,535.88 | $7,612.58 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | SMARTHEALTH | 3501_SMARTHEALTH 20230101 | $4,660.76 | $15,535.88 | $7,612.58 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | SMARTHEALTH | 3501_SMARTHEALTH 20230101 | $4,660.76 | $15,535.88 | $7,612.58 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | PRIORITY HEALTH APPLE | 2606_BOMC, BPHC PRIORITY HEALTH APPLE 20200101 | $6,835.79 | $15,535.88 | $7,612.58 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | PRIORITY HEALTH APPLE | 2606_BOMC, BPHC PRIORITY HEALTH APPLE 20200101 | $6,835.79 | $15,535.88 | $7,612.58 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | PRIORITY HEALTH APPLE | 2606_BOMC, BPHC PRIORITY HEALTH APPLE 20200101 | $6,835.79 | $15,535.88 | $7,612.58 | 2026-01-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Select Health | HIX | $6,868.59 | $22,668.61 | $22,668.61 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Select Health ICHN Brightpath | PPO | $6,868.59 | $22,668.61 | $22,668.61 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Select Health | PPO | $6,868.59 | $22,668.61 | $22,668.61 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Select Health Idaho (EIRMC only) | SelectMed | $7,231.29 | $22,668.61 | $22,668.61 | 2026-03-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | COFINITY ADVANTAGE | 2002_COFINITY ADVANTAGE 20200101 | $7,612.58 | $15,535.88 | $7,612.58 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | COFINITY ADVANTAGE | 2002_COFINITY ADVANTAGE 20200101 | $7,612.58 | $15,535.88 | $7,612.58 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | COFINITY ADVANTAGE | 2002_COFINITY ADVANTAGE 20200101 | $7,612.58 | $15,535.88 | $7,612.58 | 2026-01-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Select Health ICHN Brightpath | MED | $7,661.99 | $22,668.61 | $22,668.61 | 2026-03-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | ALLEGAN HUMANA MCR | 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001 | $8,234.02 | $15,535.88 | $7,612.58 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | AUTO MVA | 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215 | $8,234.02 | $15,535.88 | $7,612.58 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | ALLEGAN MOLINA MEDICARE | 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215 | $8,234.02 | $15,535.88 | $7,612.58 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ALLEGAN MOLINA MEDICARE | 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215 | $8,234.02 | $15,535.88 | $7,612.58 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ALLEGAN MEDICARE | 3127_BOAH MEDICARE OUTPATIENT 20231001 | $8,234.02 | $15,535.88 | $7,612.58 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ALLEGAN HUMANA MCR | 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001 | $8,234.02 | $15,535.88 | $7,612.58 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ALLEGAN HUMANA MCR | 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001 | $8,234.02 | $15,535.88 | $7,612.58 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ALLEGAN MEDICARE | 3127_BOAH MEDICARE OUTPATIENT 20231001 | $8,234.02 | $15,535.88 | $7,612.58 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ALLEGAN MOLINA MEDICARE | 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215 | $8,234.02 | $15,535.88 | $7,612.58 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | AUTO MVA | 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215 | $8,234.02 | $15,535.88 | $7,612.58 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | AUTO MVA | 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215 | $8,234.02 | $15,535.88 | $7,612.58 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | ALLEGAN MEDICARE | 3127_BOAH MEDICARE OUTPATIENT 20231001 | $8,234.02 | $15,535.88 | $7,612.58 | 2026-01-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Doug Andrus Distributing | COMM | $9,067.44 | $22,668.61 | $22,668.61 | 2026-03-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | MAGELLAN | 2050_BOMC, BPHC MAGELLAN 20210201 | $9,321.53 | $15,535.88 | $7,612.58 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | MAGELLAN | 2050_BOMC, BPHC MAGELLAN 20210201 | $9,321.53 | $15,535.88 | $7,612.58 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | PRIORITY HEALTH HMO/PPO | 2404_BOGI BOSU PRIORITY HEALTH 20200401 | $9,321.53 | $15,535.88 | $7,612.58 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | PRIORITY HEALTH HMO/PPO | 2404_BOGI BOSU PRIORITY HEALTH 20200401 | $9,321.53 | $15,535.88 | $7,612.58 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | MAGELLAN | 2050_BOMC, BPHC MAGELLAN 20210201 | $9,321.53 | $15,535.88 | $7,612.58 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | CIGNA | 2827_BOGI BOSU CIGNA 20210912 | $9,321.53 | $15,535.88 | $7,612.58 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | CIGNA | 2827_BOGI BOSU CIGNA 20210912 | $9,321.53 | $15,535.88 | $7,612.58 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | PRIORITY HEALTH HMO/PPO | 2404_BOGI BOSU PRIORITY HEALTH 20200401 | $9,321.53 | $15,535.88 | $7,612.58 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | CIGNA | 2827_BOGI BOSU CIGNA 20210912 | $9,321.53 | $15,535.88 | $7,612.58 | 2026-01-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | University of Utah | PPO | $9,520.82 | $22,668.61 | $22,668.61 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | University of Utah | HIX | $9,520.82 | $22,668.61 | $22,668.61 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | University of Utah | HMP | $9,520.82 | $22,668.61 | $22,668.61 | 2026-03-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | COFINITY | 1993_BOMC, BPHC COFINITY PPOM 20200101 | $10,719.76 | $15,535.88 | $7,612.58 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | COFINITY | 1993_BOMC, BPHC COFINITY PPOM 20200101 | $10,719.76 | $15,535.88 | $7,612.58 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | COFINITY | 1993_BOMC, BPHC COFINITY PPOM 20200101 | $10,719.76 | $15,535.88 | $7,612.58 | 2026-01-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Aetna | PEAKPERFERENCE | $11,039.61 | $22,668.61 | $22,668.61 | 2026-03-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Mountain Health Co-Op | Individual | $11,334.31 | $22,668.61 | $22,668.61 | 2026-03-01 | MRF ↗ |
| UNION COUNTY GENERAL HOSPITAL Outpatient | Blue Cross and Blue Shield of New Mexico | Commercial | $11,524.00 | $12,804.00 | $8,963.00 | 2025-06-17 | MRF ↗ |
| UNION COUNTY GENERAL HOSPITAL Outpatient | Humana Inc. | Commercial | $11,524.00 | $12,804.00 | $8,963.00 | 2025-06-17 | MRF ↗ |
| UNION COUNTY GENERAL HOSPITAL Outpatient | Aetna | Commercial | $11,524.00 | $12,804.00 | $8,963.00 | 2025-06-17 | 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.