220501 — Dicloxacillin 250mg Cap
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). DICLOXACILLIN 250MG CAP (CDM 220501) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/220501?code_type=CDM
MLA (9th ed.)
“DICLOXACILLIN 250MG CAP (CDM 220501) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/220501?code_type=CDM. Accessed .
Chicago (notes-bibliography)
“DICLOXACILLIN 250MG CAP (CDM 220501) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/220501?code_type=CDM.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $6–$11,773 (25th–75th percentile) across 3 hospitals · 60 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CDM 220501 — 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 | MCD | $2.24 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Amerigroup | CHIP | $2.24 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | BCBS | MyBlueHealth | $2.38 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Superior Health Plan | ValueHMO | $2.72 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Superior Health Plan | AmbetterEPO | $2.72 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Superior Health Plan | AmbetterHMO | $2.72 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | BCBS | BlueAdvantage | $2.80 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Imperial Insurance | MGMCR | $3.04 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Oscar | HMO | $3.07 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Oscar | HIX | $3.07 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Oscar | POS | $3.42 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Oscar | PPO | $3.42 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Oscar | EPO | $3.42 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | MODA | HIX | $3.76 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | United | OptionsPPO | $3.98 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | BCBS | BlueEssentials | $4.37 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | BCBS | BlueEssentialsAccess | $4.37 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Covenant Management Systems | HMO | $4.61 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Healthcare Highways | EPO | $4.66 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | BCBS | Traditional | $4.72 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | BCBS | EPOSOA | $4.74 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Healthcare Highways | PPO | $4.80 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | IMO Med - Select Network | WC | $4.80 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | BCBS | PPO | $5.10 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Sendero | ACHP | $5.12 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Nomi Health | COMMTier1OutofNetwork | $5.12 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Cigna | NewBusinessNetwork | $5.14 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Cigna | HMO | $5.47 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Cigna | OpenAccessPlus | $5.47 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Cigna | OpenAccess | $5.47 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Shared Health | MGMCR | $5.60 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Aetna | QHPExchange(HIX) | $5.71 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | MODA Health | EPO | $5.76 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Evry Health | BroadNetwork | $5.89 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Texas Healthcare Foundation HEB | COMM | $5.92 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Nomi Health | Tier2OutofNetwork | $5.92 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Nomi Health | COMMTier1 | $5.92 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Texas Healthcare Foundation HEB | WC | $5.92 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | MODA Health | PPO | $5.92 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Texas Workforce Commission | WCOMP | $6.24 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Curative Administrators | COMM | $6.40 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Harbor Health Team | COMMPPO | $6.40 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Cigna | PPO | $6.56 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Aetna | NarrowNetwork | $7.18 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Seven Corners | GVT | $7.20 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | United | GlobalBenefitPlan | $7.20 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | NaphCare | MGMCR | $7.20 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Averde Health | COMM | $7.20 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Optum Health | COMM | $7.20 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Aetna | Meritain | $7.60 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Aetna | COMM | $7.60 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Austin FC | WORKERSCOMP | $8.00 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Comanche County | LOCALGOV | $8.00 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | National ChoiceCare | WC | $8.00 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | HealthSmart Preferred Care | Accel | $8.80 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Independent Medical Systems | COMM | $8.80 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Physicians Cooperative of Texas | WC | $8.80 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Aetna | ASA | $8.85 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Aetna | OON | $8.94 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Prime Health | WC | $9.60 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | First Health | PPO | $10.00 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | National Health Care | COMM | $10.40 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Coastal Comp Health Networks | WORKERSCOMP | $10.40 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | First Health | PPO | $10.94 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Texas Municipal League | COMM | $11.20 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | First Health | PPO | $11.36 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | MedCorp Southwest | MCR | $12.00 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | MedCorp Southwest | MCD | $12.00 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Rockport Healthcare Group | WORKERSCOMPRockportCommunityNetwork | $12.80 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | HealthSmart Preferred Care | COMM | $12.80 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Beech Street | COMMPPO | $14.40 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Multiplan | COMMPPO | $14.40 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | BCE Emergis Corporation | COMMPPO | $14.40 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Medical Control Network Solutions | MedicalControlNetwork | $14.40 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Rockport Healthcare Group | WORKERSCOMPNewtonHealthcareNetwork | $14.40 | $16.00 | $16.00 | 2026-03-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | US HEALTH AND LIFE | 1991_BOMC, BOLE, BPHC US HEALTH AND LIFE 20200101 | $4,226.25 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | US HEALTH AND LIFE | 1991_BOMC, BOLE, BPHC US HEALTH AND LIFE 20200101 | $4,226.25 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | SMARTHEALTH | 3501_SMARTHEALTH 20230101 | $4,528.13 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | SMARTHEALTH | 3501_SMARTHEALTH 20230101 | $4,528.13 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | PRIORITY HEALTH APPLE | 2606_BOMC, BPHC PRIORITY HEALTH APPLE 20200101 | $6,641.25 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | PRIORITY HEALTH APPLE | 2606_BOMC, BPHC PRIORITY HEALTH APPLE 20200101 | $6,641.25 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | COFINITY ADVANTAGE | 2002_COFINITY ADVANTAGE 20200101 | $7,395.94 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | COFINITY ADVANTAGE | 2002_COFINITY ADVANTAGE 20200101 | $7,395.94 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ALLEGAN HUMANA MCR | 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001 | $7,999.69 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ALLEGAN MEDICARE | 3127_BOAH MEDICARE OUTPATIENT 20231001 | $7,999.69 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | ALLEGAN HUMANA MCR | 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001 | $7,999.69 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | ALLEGAN MOLINA MEDICARE | 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215 | $7,999.69 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | AUTO MVA | 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215 | $7,999.69 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | ALLEGAN MEDICARE | 3127_BOAH MEDICARE OUTPATIENT 20231001 | $7,999.69 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | AUTO MVA | 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215 | $7,999.69 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ALLEGAN MOLINA MEDICARE | 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215 | $7,999.69 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | CIGNA | 2827_BOGI BOSU CIGNA 20210912 | $9,056.25 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | PRIORITY HEALTH HMO/PPO | 2404_BOGI BOSU PRIORITY HEALTH 20200401 | $9,056.25 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | CIGNA | 2827_BOGI BOSU CIGNA 20210912 | $9,056.25 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | MAGELLAN | 2050_BOMC, BPHC MAGELLAN 20210201 | $9,056.25 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | MAGELLAN | 2050_BOMC, BPHC MAGELLAN 20210201 | $9,056.25 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | PRIORITY HEALTH HMO/PPO | 2404_BOGI BOSU PRIORITY HEALTH 20200401 | $9,056.25 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | COFINITY | 1993_BOMC, BPHC COFINITY PPOM 20200101 | $10,414.69 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | COFINITY | 1993_BOMC, BPHC COFINITY PPOM 20200101 | $10,414.69 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | PHCS | 1995_BOMC, BPHC PHCS 20200101 | $11,320.31 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | PHCS | 1971_BOGI, BOSU PHCS 20200101 | $11,320.31 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | PHCS | 1995_BOMC, BPHC PHCS 20200101 | $11,320.31 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | PHCS | 1971_BOGI, BOSU PHCS 20200101 | $11,320.31 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | ALLEGAN UHC | 3184_BOAH UNITED HEALTH CARE 20240701 | $11,622.19 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ALLEGAN UHC | 3184_BOAH UNITED HEALTH CARE 20240701 | $11,622.19 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | BC OF MICH TRAD | 3494_BOAH BLUE CROSS TRUST 20240701 | $11,773.13 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | BCBS ALL OTHER | 3496_BOAH BLUE CROSS TRADITIONAL 20240701 | $11,773.13 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | BCBS ALL OTHER | 3496_BOAH BLUE CROSS TRADITIONAL 20240701 | $11,773.13 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | CIGNA ALLEGAN | 3180_BOAH CIGNA 20230701 | $11,773.13 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | BC OF MICH TRAD | 3494_BOAH BLUE CROSS TRUST 20240701 | $11,773.13 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | CIGNA ALLEGAN | 3180_BOAH CIGNA 20230701 | $11,773.13 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ALLEGAN PRIORITY HEALTH HMO AND PPO | 3126_BOAH PRIORITY HEALTH HMO AND PPO 20100101 | $11,924.06 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | ALLEGAN PRIORITY HEALTH HMO AND PPO | 3126_BOAH PRIORITY HEALTH HMO AND PPO 20100101 | $11,924.06 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | COFINITY | 1969_BOGI, BOSU COFINITY 20200101 | $12,075.00 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | FIRST HEALTH | 1994_BOMC, BPHC, BOSU, BOGI FIRST HEALTH 20200101 | $12,075.00 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ASR CORP | 2588_BOMC, BPHC, BOLE ASR CORP 20200101 | $12,075.00 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | ASR CORP | 2588_BOMC, BPHC, BOLE ASR CORP 20200101 | $12,075.00 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | COFINITY | 1969_BOGI, BOSU COFINITY 20200101 | $12,075.00 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | FIRST HEALTH | 1994_BOMC, BPHC, BOSU, BOGI FIRST HEALTH 20200101 | $12,075.00 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | HEALTHSCOPE | 1989_BOMC, BOLE, BPHC HEALTHSCOPE 20200101 | $12,376.88 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | HEALTHSCOPE | 1989_BOMC, BOLE, BPHC HEALTHSCOPE 20200101 | $12,376.88 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | DIRECT CARE AMERICA | 2581_DIRECT CARE AMERICA 20200101 | $12,829.69 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | PREFERRED CHOICES | 2605_PREFERRED CHOICES 20200101 | $12,829.69 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | DIRECT CARE AMERICA | 2581_DIRECT CARE AMERICA 20200101 | $12,829.69 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | PREFERRED CHOICES | 2605_PREFERRED CHOICES 20200101 | $12,829.69 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | MULTIPLAN | 2393_BOMC BPHC MULTIPLAN 20190101 | $13,282.50 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | MULTIPLAN | 2393_BOMC BPHC MULTIPLAN 20190101 | $13,282.50 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | HUMANA | 2623_BOMC, BOLE, BPHC HUMANA 20210401 | $13,584.38 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | COFINITY | 1975_BOLE COFINITY 20200101 | $13,584.38 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | HUMANA | 2623_BOMC, BOLE, BPHC HUMANA 20210401 | $13,584.38 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | COFINITY | 1975_BOLE COFINITY 20200101 | $13,584.38 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | CHA | 2589_BOMC, BPHC, BOLE CHA 20200101 | $13,886.25 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | CHA | 2589_BOMC, BPHC, BOLE CHA 20200101 | $13,886.25 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | HEALTHSCOPE | 2601_BOSU, BOGI HEALTHSCOPE 20200101 | $14,339.06 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | ASR 2 | 1970_BOGI, BOSU HEALTHSCOPE 98R 20200101 | $14,339.06 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | HEALTHSCOPE | 2601_BOSU, BOGI HEALTHSCOPE 20200101 | $14,339.06 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ASR CORP | 2602_BOSU, BOGI ASR CORP 20200101 | $14,339.06 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | ASR 2 | 1970_BOGI, BOSU HEALTHSCOPE 98R 20200101 | $14,339.06 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Outpatient | ASR CORP | 2602_BOSU, BOGI ASR CORP 20200101 | $14,339.06 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| THREE RIVERS HEALTH Both | CDM DEFAULT - NON-NEGOTIATED RATE | CDM DEFAULT - NON-NEGOTIATED RATE | $15,093.75 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |
| ASCENSION BORGESS ALLEGAN HOSPITAL Both | CDM DEFAULT - NON-NEGOTIATED RATE | CDM DEFAULT - NON-NEGOTIATED RATE | $15,093.75 | $15,093.75 | $7,395.94 | 2026-01-01 | MRF ↗ |