23455 — Repair Shoulder Capsule
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). Repair shoulder capsule (OTHER 23455) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/23455?code_type=OTHER
MLA (9th ed.)
“Repair shoulder capsule (OTHER 23455) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/23455?code_type=OTHER. Accessed .
Chicago (notes-bibliography)
“Repair shoulder capsule (OTHER 23455) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/23455?code_type=OTHER.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $1,344–$8,246 (25th–75th percentile) across 206 hospitals · 471 payers.
“Negotiated” is the hospital’s negotiated facility rate for this OTHER 23455 — 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 |
|---|---|---|---|---|---|---|---|
| VIRGINIA MASON MEDICAL CENTER Outpatient | First Choice | Commercial | $29.32 | — | — | 2026-05-27 | MRF ↗ |
| VIRGINIA MASON MEDICAL CENTER Outpatient | Aetna | Medicare Advantage Hmo | $35.19 | — | — | 2026-05-27 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Arkansas Total Care | Medicaid | $42.42 | — | — | 2026-05-09 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Caresource | Medicaid | $44.11 | — | — | 2026-05-09 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Granite State Health Plan | New Hampshire Healthy Families - Nh Managed Medicaid | $88.20 | — | — | 2026-05-08 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Health Alliance | Commercial | $91.78 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Health Alliance | Commercial | $91.78 | — | — | 2026-05-24 | MRF ↗ |
| GILLETTE CHILDRENS SPECIALTY HOSPITAL Outpatient | Ucare | Managed Medicaid | $111.38 | — | — | 2026-05-09 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Humana Choicecare | Medicare | $137.42 | — | — | 2026-05-09 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Complete Blue Mcr Adv | $138.58 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Community Blue Mcr Adv | $138.58 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Community Blue Mcr Adv | $138.58 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Complete Blue Mcr Adv | $138.58 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Community Blue Mcr Adv | $138.58 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Community Blue Mcr Adv | $138.58 | — | — | 2026-05-23 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Viva | Medicare Advantage | $138.80 | — | — | 2026-05-06 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Cigna | Commercial | $138.80 | — | — | 2026-05-06 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Blue Cross | Medicare Advantage | $138.80 | — | — | 2026-05-06 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Simpra | Medicare Advantage | $138.80 | — | — | 2026-05-06 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Humana | Medicare Advantage | $138.80 | — | — | 2026-05-06 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Viva | Commercial | $138.80 | — | — | 2026-05-06 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Aetna | Commercial | $138.80 | — | — | 2026-05-06 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Freedom Blue Mcr Adv | $140.06 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS CONNELLSVILLE Outpatient | Blue Cross | Freedom Blue Mcr Adv | $140.06 | — | — | 2026-05-09 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Freedom Blue Mcr Adv | $140.06 | — | — | 2026-05-14 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Bcbs | Medicare | $140.17 | — | — | 2026-05-09 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Ambetter | Commercial | $140.17 | — | — | 2026-05-09 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Viva | Medicare Advantage | $141.29 | — | — | 2026-05-23 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Humana | Medicare Advantage | $141.29 | — | — | 2026-05-23 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Simpra | Medicare Advantage | $141.29 | — | — | 2026-05-13 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Humana | Medicare Advantage | $141.29 | — | — | 2026-05-13 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Viva | Medicare Advantage | $141.29 | — | — | 2026-05-13 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Simpra | Medicare Advantage | $141.29 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS CONNELLSVILLE Outpatient | Blue Cross | Community Blue Mcr Adv | $142.27 | — | — | 2026-05-09 | MRF ↗ |
| PENN HIGHLANDS CONNELLSVILLE Outpatient | Blue Cross | Complete Blue Mcr Adv | $142.27 | — | — | 2026-05-09 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Aetna | Coventry | $143.28 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Aetna | Coventry | $143.28 | — | — | 2026-05-23 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | United Healthcare | Commercial | $143.33 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | United Healthcare | Commercial | $143.33 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Hfn | Commercial | $143.33 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Hfn | Commercial | $143.33 | — | — | 2026-05-14 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Windsor | Medicare | $144.29 | — | — | 2026-05-09 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Cigna Healthspring | Medicare | $144.29 | — | — | 2026-05-09 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Wellcare | Medicare | $144.29 | — | — | 2026-05-09 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - My Blue Access Ppo | $147.43 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Performance Blue | $147.43 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Performance Blue | $147.43 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Indemnity | $147.43 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - All Social Mission | $147.43 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS CONNELLSVILLE Outpatient | Traditional Medicare | Traditional Medicare | $147.43 | — | — | 2026-05-09 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Managed Care | $147.43 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Traditional Medicare | Traditional Medicare | $147.43 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS CONNELLSVILLE Outpatient | Geisinger | Mcr Advantage | $147.43 | — | — | 2026-05-09 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Aca | $147.43 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - My Blue Access Ppo | $147.43 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Aca | $147.43 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Indemnity | $147.43 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Managed Care | $147.43 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Traditional Medicare | Traditional Medicare | $147.43 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - All Social Mission | $147.43 | — | — | 2026-05-23 | MRF ↗ |
| FISHER-TITUS HOSPITAL Outpatient | Optum | Vaccnoptum | $147.96 | — | — | 2026-05-27 | MRF ↗ |
| FISHER-TITUS HOSPITAL Outpatient | Perennial Advantage | Perennial Advantage | $147.96 | — | — | 2026-05-27 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Upmc | Mcr Advantage | $150.38 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Upmc | Hmo Epo | $150.38 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Upmc | Hmo Epo | $150.38 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Upmc | Mcr Advantage | $150.38 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Geisinger | Mcr Advantage | $151.85 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Humana | Mcr Advantage | $151.85 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Uhc | Mcr Advantage | $151.85 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Uhc | Mcr Advantage | $151.85 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS CONNELLSVILLE Outpatient | Uhc | Mcr Advantage | $151.85 | — | — | 2026-05-09 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Geisinger | Mcr Advantage | $151.85 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Humana | Mcr Advantage | $151.85 | — | — | 2026-05-23 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Mutual Medical | Commercial | $152.97 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | United Healthcare | Medicare | $152.97 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Humana | Medicare | $152.97 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Meridian | Medicaid Illinois | $152.97 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Medicaid | Medicaid Illinois | $152.97 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | United Healthcare | Medicare | $152.97 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Aetna | Medicare | $152.97 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Molina | Medicaid Illinois | $152.97 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Health Alliance | Medicare | $152.97 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Veteran Affairs | Traditional | $152.97 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Medicare | Medicare | $152.97 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Health Alliance | Medicare | $152.97 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Mutual Medical | Commercial | $152.97 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Veteran Affairs | Traditional | $152.97 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Humana | Medicare | $152.97 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Aetna | Medicaid | $152.97 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Medicaid | Medicaid Illinois | $152.97 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Molina | Medicaid Illinois | $152.97 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Aetna | Medicaid | $152.97 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Aetna | Medicare | $152.97 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Meridian | Medicaid Illinois | $152.97 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Medicare | Medicare | $152.97 | — | — | 2026-05-24 | MRF ↗ |
| FISHER-TITUS HOSPITAL Outpatient | Sidecar | Sidecarcommercial | $153.42 | — | — | 2026-05-27 | MRF ↗ |
| GRADY MEMORIAL HOSPITAL Outpatient | Amerigroup | Medicaid | $153.57 | — | — | 2026-05-07 | MRF ↗ |
| JASPER MEMORIAL HOSPITAL Outpatient | Caresource | Commercial | $153.57 | — | — | 2026-05-06 | MRF ↗ |
| GRADY MEMORIAL HOSPITAL Outpatient | Caresource | Commercial | $153.57 | — | — | 2026-05-07 | MRF ↗ |
| GRADY MEMORIAL HOSPITAL Outpatient | Peach State | Medicaid | $153.57 | — | — | 2026-05-07 | MRF ↗ |
| JASPER MEMORIAL HOSPITAL Outpatient | Peach State | Medicaid | $153.57 | — | — | 2026-05-06 | MRF ↗ |
| JASPER MEMORIAL HOSPITAL Outpatient | Amerigroup | Medicaid | $153.57 | — | — | 2026-05-06 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Bcbs Of Vermont | Bcbs Of Vermont - Medicare Advantage - Dhp | $153.78 | — | — | 2026-05-08 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Martin'S Point Generations Advantage | Martin'S Point - Medicare Advantage - Dhp | $153.78 | — | — | 2026-05-08 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Mvp | Mvp - Medicare Advantage - Dhp | $153.78 | — | — | 2026-05-08 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Anthem Health Plans Of Nh | Anthem - Medicare Advantage - Dhp | $153.78 | — | — | 2026-05-08 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Unitedhealthcare | Uhc - Va Community Care Network - Dhpn | $153.78 | — | — | 2026-05-08 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Unitedhealthcare | Uhc - Medicare Advantage - Dhp | $153.78 | — | — | 2026-05-08 | MRF ↗ |
| INTERMOUNTAIN HEALTH SPANISH FORK HOSPITAL Outpatient | Aetna | Medicare Adv Hmo | $153.88 | — | — | 2026-05-15 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Selecthealth | Medicare Advantage | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SPANISH FORK HOSPITAL Outpatient | American Health | Medicare Adv Ut Hmo I-Snp | $153.88 | — | — | 2026-05-15 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Selecthealth | Medicaid | $153.88 | — | — | 2026-05-13 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Humana | Medicare Choice Ppo | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SPANISH FORK HOSPITAL Outpatient | Aetna | Medicare Adv Ppo | $153.88 | — | — | 2026-05-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH SPANISH FORK HOSPITAL Outpatient | Selecthealth | Medicaid | $153.88 | — | — | 2026-05-15 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | American Health | Medicare Adv Ut Hmo I-Snp | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Health Partners Of Nevada | Medicare Advantage | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| CABELL HUNTINGTON HOSPITAL, INC Outpatient | Peia | Other Governmental | $153.88 | — | — | 2026-05-14 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Southwest Behavioral Health | Behavioral Health | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Selecthealth | Medicaid | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Aetna | Medicare Adv Ppo | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Molina | Medicaid | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Aetna | Medicare Adv Hmo | $153.88 | — | — | 2026-05-14 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Healthy U | Medicaid | $153.88 | — | — | 2026-05-13 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Molina | Medicaid | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Healthy U | Medicaid | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Selecthealth | Medicaid | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Selecthealth | Med Individual Aca | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Regence Bcbs | Medadvantage Ppo | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Aetna | Medicare Adv Hmo | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | American Health | Medicare Adv Ut Hmo I-Snp | $153.88 | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH SPANISH FORK HOSPITAL Outpatient | Selecthealth | Signature Individual Aca | $153.88 | — | — | 2026-05-15 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Health Plan Of Nevada | Medicaid | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Uhc | Medicare Advantage | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Humana | Medicare Choice Ppo | $153.88 | — | — | 2026-05-14 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Aetna | Medicare Adv Hmo | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Aetna | Medicare Adv Ppo | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Uhc | Medicare Advantage | $153.88 | — | — | 2026-05-14 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Uhc | Medicare Advantage | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Humana | Medicare Choice Ppo | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Healthy U | Medicaid | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Aetna | Medicare Adv Ppo | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| CABELL HUNTINGTON HOSPITAL, INC Outpatient | Highmark Blue Cross | Medicare | $153.88 | — | — | 2026-05-14 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Aetna | Medicare Adv Ppo | $153.88 | — | — | 2026-05-14 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Molina | Medicare Complete Care Hmo Snp | $153.88 | — | — | 2026-05-13 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Molina | Medicare Complete Care Hmo Snp | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Molina | Medicare Advantage | $153.88 | — | — | 2026-05-13 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Molina | Medicare Choice Care Hmo | $153.88 | — | — | 2026-05-13 | MRF ↗ |
| CABELL HUNTINGTON HOSPITAL, INC Outpatient | Highmark Blue Cross | Ppo/Pos | $153.88 | — | — | 2026-05-14 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Molina | Medicare Choice Care Hmo | $153.88 | — | — | 2026-05-13 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Health Plan Of Nevada | Medicaid | $153.88 | — | — | 2026-05-13 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Molina | Medicare Complete Care Hmo Snp | $153.88 | — | — | 2026-05-13 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Uhc | Medicare Advantage | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Selecthealth | Medicaid | $153.88 | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | American Health | Medicare Adv Ut Hmo I-Snp | $153.88 | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH SPANISH FORK HOSPITAL Outpatient | Selecthealth | Value Individual Aca | $153.88 | — | — | 2026-05-15 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Molina | Medicare Choice Care Hmo | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Molina | Medicaid | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Regence Bcbs | Medadvantage Ppo | $153.88 | — | — | 2026-05-14 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Molina | Medicaid | $153.88 | — | — | 2026-05-13 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Uhc | Medicare Advantage | $153.88 | — | — | 2026-05-13 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Health Plan Of Nevada | Medicaid | $153.88 | — | — | 2026-05-14 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Health Partners Of Nevada | Medicare Advantage | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Southwest Behavioral Health | Behavioral Health | $153.88 | — | — | 2026-05-13 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | American Health | Medicare Adv Ut Hmo I-Snp | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | American Health | Medicare Adv Ut Hmo I-Snp | $153.88 | — | — | 2026-05-13 | MRF ↗ |
| CABELL HUNTINGTON HOSPITAL, INC Outpatient | Peak Health | Medicare | $153.88 | — | — | 2026-05-14 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Molina | Medicaid | $153.88 | — | — | 2026-05-14 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Aetna | Medicare Adv Hmo | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Aetna | Medicare Adv Ppo | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Healthy U | Medicaid | $153.88 | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Regence Bcbs | Medadvantage Ppo | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Uhc | Medicare Advantage | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | American Health | Medicare Adv Ut Hmo I-Snp | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| CABELL HUNTINGTON HOSPITAL, INC Outpatient | Aetna | Medicare | $153.88 | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Health Plan Of Nevada | Medicaid | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Selecthealth | Medicare Advantage | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Molina | Medicare Advantage | $153.88 | — | — | 2026-05-13 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Health Partners Of Nevada | Medicare Advantage | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Aetna | Medicare Adv Hmo | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Humana | Medicare Choice Ppo | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Selecthealth | Value Individual Aca | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Selecthealth | Medicare Advantage | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Molina | Medicare Choice Care Hmo | $153.88 | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Selecthealth | Medicare Advantage | $153.88 | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH SPANISH FORK HOSPITAL Outpatient | Humana | Medicare Choice Ppo | $153.88 | — | — | 2026-05-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Selecthealth | Medicaid | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | American Health | Medicare Adv Ut Hmo I-Snp | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Healthy U | Medicaid | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Uhc | Medicare Advantage | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Humana | Medicare Choice Ppo | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Health Partners Of Nevada | Medicare Advantage | $153.88 | — | — | 2026-05-14 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Aetna | Medicare Adv Hmo | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Molina | Medicare Advantage | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Molina | Medicare Complete Care Hmo Snp | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Molina | Medicare Choice Care Hmo | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Healthy U | Medicaid | $153.88 | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Uhc | Medicare Advantage | $153.88 | — | — | 2026-05-14 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Selecthealth | Signature Individual Aca | $153.88 | — | — | 2026-05-09 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Selecthealth | Medicaid | $153.88 | — | — | 2026-05-09 | 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.