220281 — Brentuximab Vl 50mg, Per 1mg
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). BRENTUXIMAB VL 50MG, PER 1MG (CDM 220281) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/220281?code_type=CDM
MLA (9th ed.)
“BRENTUXIMAB VL 50MG, PER 1MG (CDM 220281) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/220281?code_type=CDM. Accessed .
Chicago (notes-bibliography)
“BRENTUXIMAB VL 50MG, PER 1MG (CDM 220281) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/220281?code_type=CDM.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $1,364–$15,180 (25th–75th percentile) across 4 hospitals · 42 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CDM 220281 — 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 |
|---|---|---|---|---|---|---|---|
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Health Services Coalition | COMM | $8.84 | $65.00 | $65.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Imperial NV | MCR | $9.75 | $65.00 | $65.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Aetna | HMO | $13.32 | $65.00 | $65.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Aetna | PPO | $13.32 | $65.00 | $65.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Centene | HIX | $13.65 | $65.00 | $65.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Select Health | HIX | $14.04 | $65.00 | $65.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | United | OptionsPPO | $14.17 | $65.00 | $65.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | CIGNA | OAP | $14.56 | $65.00 | $65.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Select Health | COMM | $14.98 | $65.00 | $65.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Prominence HealthFirst | COMM | $19.50 | $65.00 | $65.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | CMN Global | COMM | $27.30 | $65.00 | $65.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Evernorth | COMM | $32.50 | $65.00 | $65.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Hometown Health Providers | HMO/PPO/POS | $32.50 | $65.00 | $65.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Hometown Health Providers | ThirdPartyAdministratior(TPA) | $32.50 | $65.00 | $65.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | NV Health & Welfare Trust | COMM | $39.00 | $65.00 | $65.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | MultiPlan | INTERNATIONAL | $40.95 | $65.00 | $65.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | MultiPlan | PRIMARY | $40.95 | $65.00 | $65.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | First Health | COMMPPO | $42.90 | $65.00 | $65.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | MultiPlan | COMPLEMENTARY | $47.45 | $65.00 | $65.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Olympus MedSave USA | COMM | $48.75 | $65.00 | $65.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | MedCare International | COMM | $48.75 | $65.00 | $65.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | First Health | WC | $52.00 | $65.00 | $65.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Elevance (Anthem BCBS) | MCR | $65.00 | $65.00 | $65.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE TOMBALL Outpatient | Aetna | MCR | $630.05 | $9,503.00 | $9,503.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE TOMBALL Outpatient | Community Health Choice MCD | CHIPPerinatal | $1,235.39 | $9,503.00 | $9,503.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE TOMBALL Outpatient | Community Health Choice MCD | STAR | $1,235.39 | $9,503.00 | $9,503.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE TOMBALL Outpatient | Community Health Choice MCD | STAR+PLUS | $1,235.39 | $9,503.00 | $9,503.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE TOMBALL Outpatient | Community Health Choice MCD | CHIP | $1,235.39 | $9,503.00 | $9,503.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE TOMBALL Outpatient | Cigna | CSN | $1,406.44 | $9,503.00 | $9,503.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE TOMBALL Outpatient | Cigna | OpenAccessPlus | $1,520.48 | $9,503.00 | $9,503.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE TOMBALL Outpatient | BCBS | MyBlueHealth | $1,548.99 | $9,503.00 | $9,503.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE TOMBALL Outpatient | United | OptionsPPO | $1,596.50 | $9,503.00 | $9,503.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE TOMBALL Outpatient | Superior | HMO | $1,663.03 | $9,503.00 | $9,503.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE TOMBALL Outpatient | Superior | EPO | $1,663.03 | $9,503.00 | $9,503.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE TOMBALL Outpatient | BCBS | BAV | $1,710.54 | $9,503.00 | $9,503.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE TOMBALL Outpatient | Cigna | PPO | $1,805.57 | $9,503.00 | $9,503.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE TOMBALL Outpatient | Superior | ValueHMO | $1,881.59 | $9,503.00 | $9,503.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE TOMBALL Outpatient | BCBS | HMO | $2,138.18 | $9,503.00 | $9,503.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE TOMBALL Outpatient | BCBS | EPOSOA | $2,185.69 | $9,503.00 | $9,503.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE TOMBALL Outpatient | BCBS | PPO | $2,223.70 | $9,503.00 | $9,503.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE TOMBALL Outpatient | Molina Healthcare | HIX | $2,565.81 | $9,503.00 | $9,503.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE TOMBALL Outpatient | CHC Harris Health | Indigent | $2,850.90 | $9,503.00 | $9,503.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE TOMBALL Outpatient | BCBS | Traditional | $3,326.05 | $9,503.00 | $9,503.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE TOMBALL Outpatient | Coventry National First Health | COMM | $3,459.09 | $9,503.00 | $9,503.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE TOMBALL Outpatient | Christus (USFHP) | TRICARE | $3,801.20 | $9,503.00 | $9,503.00 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE TOMBALL Outpatient | United | GlobalAppendix | $4,276.35 | $9,503.00 | $9,503.00 | 2026-03-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | US HEALTH AND LIFE | 1991_BOMC, BOLE, BPHC US HEALTH AND LIFE 20200101 | $5,363.40 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | US HEALTH AND LIFE | 1991_BOMC, BOLE, BPHC US HEALTH AND LIFE 20200101 | $5,363.40 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | SMARTHEALTH | 3501_SMARTHEALTH 20230101 | $5,746.50 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | SMARTHEALTH | 3501_SMARTHEALTH 20230101 | $5,746.50 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | PRIORITY HEALTH APPLE | 2606_BOMC, BPHC PRIORITY HEALTH APPLE 20200101 | $8,428.20 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | PRIORITY HEALTH APPLE | 2606_BOMC, BPHC PRIORITY HEALTH APPLE 20200101 | $8,428.20 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | COFINITY ADVANTAGE | 2002_COFINITY ADVANTAGE 20200101 | $9,385.95 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | COFINITY ADVANTAGE | 2002_COFINITY ADVANTAGE 20200101 | $9,385.95 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | ALLEGAN MEDICARE | 3127_BOAH MEDICARE OUTPATIENT 20231001 | $10,152.15 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | ALLEGAN MOLINA MEDICARE | 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215 | $10,152.15 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ALLEGAN HUMANA MCR | 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001 | $10,152.15 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ALLEGAN MEDICARE | 3127_BOAH MEDICARE OUTPATIENT 20231001 | $10,152.15 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | AUTO MVA | 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215 | $10,152.15 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ALLEGAN MOLINA MEDICARE | 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215 | $10,152.15 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | AUTO MVA | 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215 | $10,152.15 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | ALLEGAN HUMANA MCR | 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001 | $10,152.15 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | MAGELLAN | 2050_BOMC, BPHC MAGELLAN 20210201 | $11,493.00 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | CIGNA | 2827_BOGI BOSU CIGNA 20210912 | $11,493.00 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | CIGNA | 2827_BOGI BOSU CIGNA 20210912 | $11,493.00 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | PRIORITY HEALTH HMO/PPO | 2404_BOGI BOSU PRIORITY HEALTH 20200401 | $11,493.00 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | MAGELLAN | 2050_BOMC, BPHC MAGELLAN 20210201 | $11,493.00 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | PRIORITY HEALTH HMO/PPO | 2404_BOGI BOSU PRIORITY HEALTH 20200401 | $11,493.00 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | COFINITY | 1993_BOMC, BPHC COFINITY PPOM 20200101 | $13,216.95 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | COFINITY | 1993_BOMC, BPHC COFINITY PPOM 20200101 | $13,216.95 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | PHCS | 1971_BOGI, BOSU PHCS 20200101 | $14,366.25 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | PHCS | 1995_BOMC, BPHC PHCS 20200101 | $14,366.25 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | PHCS | 1971_BOGI, BOSU PHCS 20200101 | $14,366.25 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | PHCS | 1995_BOMC, BPHC PHCS 20200101 | $14,366.25 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | ALLEGAN UHC | 3184_BOAH UNITED HEALTH CARE 20240701 | $14,749.35 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ALLEGAN UHC | 3184_BOAH UNITED HEALTH CARE 20240701 | $14,749.35 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | BCBS ALL OTHER | 3496_BOAH BLUE CROSS TRADITIONAL 20240701 | $14,940.90 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | CIGNA ALLEGAN | 3180_BOAH CIGNA 20230701 | $14,940.90 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | BC OF MICH TRAD | 3494_BOAH BLUE CROSS TRUST 20240701 | $14,940.90 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | CIGNA ALLEGAN | 3180_BOAH CIGNA 20230701 | $14,940.90 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | BCBS ALL OTHER | 3496_BOAH BLUE CROSS TRADITIONAL 20240701 | $14,940.90 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | BC OF MICH TRAD | 3494_BOAH BLUE CROSS TRUST 20240701 | $14,940.90 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | ALLEGAN PRIORITY HEALTH HMO AND PPO | 3126_BOAH PRIORITY HEALTH HMO AND PPO 20100101 | $15,132.45 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ALLEGAN PRIORITY HEALTH HMO AND PPO | 3126_BOAH PRIORITY HEALTH HMO AND PPO 20100101 | $15,132.45 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | COFINITY | 1969_BOGI, BOSU COFINITY 20200101 | $15,324.00 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | FIRST HEALTH | 1994_BOMC, BPHC, BOSU, BOGI FIRST HEALTH 20200101 | $15,324.00 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | COFINITY | 1969_BOGI, BOSU COFINITY 20200101 | $15,324.00 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | ASR CORP | 2588_BOMC, BPHC, BOLE ASR CORP 20200101 | $15,324.00 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | FIRST HEALTH | 1994_BOMC, BPHC, BOSU, BOGI FIRST HEALTH 20200101 | $15,324.00 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ASR CORP | 2588_BOMC, BPHC, BOLE ASR CORP 20200101 | $15,324.00 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | HEALTHSCOPE | 1989_BOMC, BOLE, BPHC HEALTHSCOPE 20200101 | $15,707.10 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | HEALTHSCOPE | 1989_BOMC, BOLE, BPHC HEALTHSCOPE 20200101 | $15,707.10 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | PREFERRED CHOICES | 2605_PREFERRED CHOICES 20200101 | $16,281.75 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | PREFERRED CHOICES | 2605_PREFERRED CHOICES 20200101 | $16,281.75 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | DIRECT CARE AMERICA | 2581_DIRECT CARE AMERICA 20200101 | $16,281.75 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | DIRECT CARE AMERICA | 2581_DIRECT CARE AMERICA 20200101 | $16,281.75 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | MULTIPLAN | 2393_BOMC BPHC MULTIPLAN 20190101 | $16,856.40 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | MULTIPLAN | 2393_BOMC BPHC MULTIPLAN 20190101 | $16,856.40 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | HUMANA | 2623_BOMC, BOLE, BPHC HUMANA 20210401 | $17,239.50 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | COFINITY | 1975_BOLE COFINITY 20200101 | $17,239.50 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | HUMANA | 2623_BOMC, BOLE, BPHC HUMANA 20210401 | $17,239.50 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | COFINITY | 1975_BOLE COFINITY 20200101 | $17,239.50 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | CHA | 2589_BOMC, BPHC, BOLE CHA 20200101 | $17,622.60 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | CHA | 2589_BOMC, BPHC, BOLE CHA 20200101 | $17,622.60 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | ASR 2 | 1970_BOGI, BOSU HEALTHSCOPE 98R 20200101 | $18,197.25 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ASR 2 | 1970_BOGI, BOSU HEALTHSCOPE 98R 20200101 | $18,197.25 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ASR CORP | 2602_BOSU, BOGI ASR CORP 20200101 | $18,197.25 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | HEALTHSCOPE | 2601_BOSU, BOGI HEALTHSCOPE 20200101 | $18,197.25 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | HEALTHSCOPE | 2601_BOSU, BOGI HEALTHSCOPE 20200101 | $18,197.25 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | ASR CORP | 2602_BOSU, BOGI ASR CORP 20200101 | $18,197.25 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Both | CDM DEFAULT - NON-NEGOTIATED RATE | CDM DEFAULT - NON-NEGOTIATED RATE | $19,155.00 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Both | CDM DEFAULT - NON-NEGOTIATED RATE | CDM DEFAULT - NON-NEGOTIATED RATE | $19,155.00 | $19,155.00 | $9,385.95 | 2026-01-01 | MRF ↗ |