220462 — Dapsone 25mg Tablet
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). DAPSONE 25MG TABLET (CDM 220462) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/220462?code_type=CDM
MLA (9th ed.)
“DAPSONE 25MG TABLET (CDM 220462) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/220462?code_type=CDM. Accessed .
Chicago (notes-bibliography)
“DAPSONE 25MG TABLET (CDM 220462) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/220462?code_type=CDM.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $4–$11,493 (25th–75th percentile) across 5 hospitals · 73 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CDM 220462 — 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 | Amerigroup | CHIP | $1.54 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Amerigroup | MCD | $1.54 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | BCBS | MyBlueHealth | $1.64 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Superior Health Plan | ValueHMO | $1.87 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Superior Health Plan | AmbetterHMO | $1.87 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Superior Health Plan | AmbetterEPO | $1.87 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | BCBS | BlueAdvantage | $1.93 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Imperial Insurance | MGMCR | $2.09 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Oscar | HMO | $2.11 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Oscar | HIX | $2.11 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Oscar | EPO | $2.35 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Oscar | PPO | $2.35 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Oscar | POS | $2.35 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | Health Services Coalition | COMM | $2.58 | $19.00 | $19.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | MODA | HIX | $2.58 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | United | OptionsPPO | $2.74 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | Imperial NV | MCR | $2.85 | $19.00 | $19.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | BCBS | BlueEssentials | $3.00 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | BCBS | BlueEssentialsAccess | $3.00 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Covenant Management Systems | HMO | $3.17 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Healthcare Highways | EPO | $3.20 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | BCBS | Traditional | $3.25 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | BCBS | EPOSOA | $3.26 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Healthcare Highways | PPO | $3.30 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | IMO Med - Select Network | WC | $3.30 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | BCBS | PPO | $3.51 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Nomi Health | COMMTier1OutofNetwork | $3.52 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Sendero | ACHP | $3.52 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Cigna | NewBusinessNetwork | $3.53 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Cigna | OpenAccessPlus | $3.76 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Cigna | OpenAccess | $3.76 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Cigna | HMO | $3.76 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Shared Health | MGMCR | $3.85 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Aetna | QHPExchange(HIX) | $3.93 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | MODA Health | EPO | $3.96 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | Centene | HIX | $3.99 | $19.00 | $19.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Evry Health | BroadNetwork | $4.05 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Texas Healthcare Foundation HEB | WC | $4.07 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | MODA Health | PPO | $4.07 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Nomi Health | Tier2OutofNetwork | $4.07 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Nomi Health | COMMTier1 | $4.07 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Texas Healthcare Foundation HEB | COMM | $4.07 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | Select Health | HIX | $4.10 | $19.00 | $19.00 | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | United | OptionsPPO | $4.14 | $19.00 | $19.00 | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | CIGNA | OAP | $4.26 | $19.00 | $19.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Texas Workforce Commission | WCOMP | $4.29 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | Select Health | COMM | $4.38 | $19.00 | $19.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Harbor Health Team | COMMPPO | $4.40 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Curative Administrators | COMM | $4.40 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Cigna | PPO | $4.51 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | Aetna | HMO | $4.84 | $19.00 | $19.00 | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | Aetna | PPO | $4.84 | $19.00 | $19.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Aetna | NarrowNetwork | $4.94 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | United | GlobalBenefitPlan | $4.95 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Optum Health | COMM | $4.95 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | NaphCare | MGMCR | $4.95 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Seven Corners | GVT | $4.95 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Averde Health | COMM | $4.95 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Aetna | COMM | $5.22 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Aetna | Meritain | $5.22 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Austin FC | WORKERSCOMP | $5.50 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Comanche County | LOCALGOV | $5.50 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | National ChoiceCare | WC | $5.50 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | Prominence HealthFirst | COMM | $5.70 | $19.00 | $19.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | HealthSmart Preferred Care | Accel | $6.05 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Independent Medical Systems | COMM | $6.05 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Physicians Cooperative of Texas | WC | $6.05 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Aetna | ASA | $6.08 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Aetna | OON | $6.15 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Prime Health | WC | $6.60 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | First Health | PPO | $6.88 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | National Health Care | COMM | $7.15 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Coastal Comp Health Networks | WORKERSCOMP | $7.15 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | First Health | PPO | $7.52 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Texas Municipal League | COMM | $7.70 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | First Health | PPO | $7.81 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | CMN Global | COMM | $7.98 | $19.00 | $19.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | MedCorp Southwest | MCR | $8.25 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | MedCorp Southwest | MCD | $8.25 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | HealthSmart Preferred Care | COMM | $8.80 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Rockport Healthcare Group | WORKERSCOMPRockportCommunityNetwork | $8.80 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | Emerging Therapy Solutions | MGMCR | $9.31 | $19.00 | $19.00 | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | Hometown Health Providers | ThirdPartyAdministratior(TPA) | $9.50 | $19.00 | $19.00 | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | Hometown Health Providers | HMO/PPO/POS | $9.50 | $19.00 | $19.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Multiplan | COMMPPO | $9.90 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Beech Street | COMMPPO | $9.90 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Rockport Healthcare Group | WORKERSCOMPNewtonHealthcareNetwork | $9.90 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | BCE Emergis Corporation | COMMPPO | $9.90 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Medical Control Network Solutions | MedicalControlNetwork | $9.90 | $11.00 | $11.00 | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | NV Health & Welfare Trust | COMM | $11.40 | $19.00 | $19.00 | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | MultiPlan | INTERNATIONAL | $11.97 | $19.00 | $19.00 | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | MultiPlan | PRIMARY | $11.97 | $19.00 | $19.00 | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | First Health | COMM | $12.54 | $19.00 | $19.00 | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | Emerging Therapy Solutions | COMM | $12.73 | $19.00 | $19.00 | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | MultiPlan | COMPLEMENTARY | $13.87 | $19.00 | $19.00 | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | Olympus MedSave USA | COMM | $14.25 | $19.00 | $19.00 | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | MedCare International | COMM | $14.25 | $19.00 | $19.00 | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | First Health | WCOMP | $15.20 | $19.00 | $19.00 | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | Elevance (Anthem BCBS) | MCR | $19.00 | $19.00 | $19.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Health Services Coalition | COMM | $73.03 | $537.00 | $537.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Imperial NV | MCR | $80.55 | $537.00 | $537.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Aetna | HMO | $110.08 | $537.00 | $537.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Aetna | PPO | $110.08 | $537.00 | $537.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Centene | HIX | $112.77 | $537.00 | $537.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Select Health | HIX | $115.99 | $537.00 | $537.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | United | OptionsPPO | $117.07 | $537.00 | $537.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | CIGNA | OAP | $120.29 | $537.00 | $537.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Select Health | COMM | $123.78 | $537.00 | $537.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Prominence HealthFirst | COMM | $161.10 | $537.00 | $537.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | CMN Global | COMM | $225.54 | $537.00 | $537.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Hometown Health Providers | ThirdPartyAdministratior(TPA) | $268.50 | $537.00 | $537.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Hometown Health Providers | HMO/PPO/POS | $268.50 | $537.00 | $537.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Evernorth | COMM | $268.50 | $537.00 | $537.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | NV Health & Welfare Trust | COMM | $322.20 | $537.00 | $537.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | MultiPlan | PRIMARY | $338.31 | $537.00 | $537.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | MultiPlan | INTERNATIONAL | $338.31 | $537.00 | $537.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | First Health | COMMPPO | $354.42 | $537.00 | $537.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | MultiPlan | COMPLEMENTARY | $392.01 | $537.00 | $537.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Olympus MedSave USA | COMM | $402.75 | $537.00 | $537.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | MedCare International | COMM | $402.75 | $537.00 | $537.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | First Health | WC | $429.60 | $537.00 | $537.00 | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Elevance (Anthem BCBS) | MCR | $537.00 | $537.00 | $537.00 | 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 ↗ |
| 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 | 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 HUMANA MCR | 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001 | $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 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 | ALLEGAN MEDICARE | 3127_BOAH MEDICARE OUTPATIENT 20231001 | $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 ↗ |
| 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 MEDICARE | 3127_BOAH MEDICARE OUTPATIENT 20231001 | $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 | MAGELLAN | 2050_BOMC, BPHC MAGELLAN 20210201 | $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 ↗ |
| 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 | CIGNA | 2827_BOGI BOSU CIGNA 20210912 | $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 ↗ |
| 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 ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL 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 ↗ |
| THREE RIVERS HEALTH 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 ↗ |
| 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 | 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 | CIGNA ALLEGAN | 3180_BOAH CIGNA 20230701 | $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 | CIGNA ALLEGAN | 3180_BOAH CIGNA 20230701 | $14,940.90 | $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 | 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 | 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 | 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 ↗ |
| 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 ↗ |
| 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 ↗ |
| 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 ↗ |
| 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 ↗ |
| THREE RIVERS HEALTH 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 | 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 | 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 | 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 ↗ |
| THREE RIVERS HEALTH Outpatient | PREFERRED CHOICES | 2605_PREFERRED CHOICES 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 ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | COFINITY | 1975_BOLE COFINITY 20200101 | $17,239.50 | $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 ↗ |
| 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 | HUMANA | 2623_BOMC, BOLE, BPHC HUMANA 20210401 | $17,239.50 | $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 | CHA | 2589_BOMC, BPHC, BOLE CHA 20200101 | $17,622.60 | $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 ↗ |
| 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 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 | ASR 2 | 1970_BOGI, BOSU HEALTHSCOPE 98R 20200101 | $18,197.25 | $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 ↗ |
| 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 ↗ |