25607 — Optx Dst Rd Xartc Fx/epi Sep
Cite this view
HANK Price Transparency. (n.d.). Optx dst rd xartc fx/epi sep (OTHER 25607) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/25607?code_type=OTHER
“Optx dst rd xartc fx/epi sep (OTHER 25607) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/25607?code_type=OTHER. Accessed .
“Optx dst rd xartc fx/epi sep (OTHER 25607) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/25607?code_type=OTHER.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $2,015–$9,242 (25th–75th percentile) across 290 hospitals · 859 payers.
“Negotiated” is the hospital’s negotiated facility rate for this OTHER 25607 — 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 |
|---|---|---|---|---|---|---|---|
| Arkansas Children's Hospital Outpatient | United Healthcare | All Plans | — | $0.01 | $0.01 | 2026-05-13 | MRF ↗ |
| Arkansas Children's Hospital Outpatient | United Healthcare | All Plans | — | $0.01 | $0.01 | 2026-05-23 | MRF ↗ |
| VIRGINIA MASON MEDICAL CENTER Outpatient | First Choice | Commercial | $21.81 | — | — | 2026-05-27 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Arkansas Total Care | Medicaid | $26.16 | — | — | 2026-05-09 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Caresource | Medicaid | $27.21 | — | — | 2026-05-09 | MRF ↗ |
| CROUSE HOSPITAL Outpatient | United Health | Medicaid | $45.61 | $351.00 | $351.00 | 2026-05-22 | MRF ↗ |
| CROUSE HOSPITAL Outpatient | United Health | Essential Plans 1 -4 | $45.61 | $351.00 | $351.00 | 2026-05-22 | MRF ↗ |
| CROUSE HOSPITAL Outpatient | United Health | Medicaid | $45.61 | $351.00 | $351.00 | 2026-05-13 | MRF ↗ |
| CROUSE HOSPITAL Outpatient | United Health | Essential Plans 1 -4 | $45.61 | $351.00 | $351.00 | 2026-05-13 | MRF ↗ |
| VIRGINIA MASON MEDICAL CENTER Outpatient | Aetna | Medicare Advantage | $59.03 | — | — | 2026-05-27 | MRF ↗ |
| CROUSE HOSPITAL Outpatient | Excellus | Govt Programs/ Special Products | $66.83 | $351.00 | $351.00 | 2026-05-22 | MRF ↗ |
| CROUSE HOSPITAL Outpatient | Excellus | Govt Programs/ Special Products | $66.83 | $351.00 | $351.00 | 2026-05-13 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Granite State Health Plan | New Hampshire Healthy Families - Nh Managed Medicaid | $68.08 | — | — | 2026-05-08 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Health Alliance | Commercial | $70.13 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Health Alliance | Commercial | $70.13 | — | — | 2026-05-24 | MRF ↗ |
| VIRGINIA MASON MEDICAL CENTER Outpatient | Confluence Health | Medicare Advantage | $73.16 | — | — | 2026-05-27 | MRF ↗ |
| GILLETTE CHILDRENS SPECIALTY HOSPITAL Outpatient | Ucare | Managed Medicaid | $85.56 | — | — | 2026-05-09 | MRF ↗ |
| GRADY MEMORIAL HOSPITAL Outpatient | Peach State | Medicaid | $86.29 | — | — | 2026-05-07 | MRF ↗ |
| JASPER MEMORIAL HOSPITAL Outpatient | Peach State | Medicaid | $86.29 | — | — | 2026-05-06 | MRF ↗ |
| JASPER MEMORIAL HOSPITAL Outpatient | Caresource | Commercial | $86.29 | — | — | 2026-05-06 | MRF ↗ |
| GRADY MEMORIAL HOSPITAL Outpatient | Amerigroup | Medicaid | $86.29 | — | — | 2026-05-07 | MRF ↗ |
| GRADY MEMORIAL HOSPITAL Outpatient | Caresource | Commercial | $86.29 | — | — | 2026-05-07 | MRF ↗ |
| JASPER MEMORIAL HOSPITAL Outpatient | Amerigroup | Medicaid | $86.29 | — | — | 2026-05-06 | MRF ↗ |
| CROUSE HOSPITAL Outpatient | Aetna | Commercial | $97.43 | $351.00 | $351.00 | 2026-05-13 | MRF ↗ |
| CROUSE HOSPITAL Outpatient | Aetna | Commercial | $97.43 | $351.00 | $351.00 | 2026-05-22 | MRF ↗ |
| CHILDREN'S HOSPITALS & CLINICS OF MN Outpatient | Wi Ma Professional | Wi Ma Professional | $104.91 | $2,651.00 | $2,651.00 | 2026-05-14 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Humana Choicecare | Medicare | $105.37 | — | — | 2026-05-09 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Simpra | Medicare Advantage | $106.46 | — | — | 2026-05-06 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Blue Cross | Medicare Advantage | $106.46 | — | — | 2026-05-06 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Aetna | Coventry | $106.46 | — | — | 2026-05-23 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Viva | Commercial | $106.46 | — | — | 2026-05-06 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Viva | Medicare Advantage | $106.46 | — | — | 2026-05-06 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Aetna | Coventry | $106.46 | — | — | 2026-05-14 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Aetna | Commercial | $106.46 | — | — | 2026-05-06 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Humana | Medicare Advantage | $106.46 | — | — | 2026-05-06 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Cigna | Commercial | $106.46 | — | — | 2026-05-06 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Community Blue Mcr Adv | $106.51 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Complete Blue Mcr Adv | $106.51 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Community Blue Mcr Adv | $106.51 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Complete Blue Mcr Adv | $106.51 | — | — | 2026-05-14 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Humana | Medicare Advantage | $106.57 | — | — | 2026-05-13 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Simpra | Medicare Advantage | $106.57 | — | — | 2026-05-23 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Simpra | Medicare Advantage | $106.57 | — | — | 2026-05-13 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Viva | Medicare Advantage | $106.57 | — | — | 2026-05-13 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Humana | Medicare Advantage | $106.57 | — | — | 2026-05-23 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Viva | Medicare Advantage | $106.57 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Upmc | Commercial | $106.87 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Upmc | Commercial | $106.87 | — | — | 2026-05-23 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | United Healthcare | Commercial | $107.00 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | United Healthcare | Commercial | $107.00 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Hfn | Commercial | $107.00 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Hfn | Commercial | $107.00 | — | — | 2026-05-24 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Bcbs | Medicare | $107.48 | — | — | 2026-05-09 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Ambetter | Commercial | $107.48 | — | — | 2026-05-09 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Freedom Blue Mcr Adv | $107.65 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS CONNELLSVILLE Outpatient | Blue Cross | Freedom Blue Mcr Adv | $107.65 | — | — | 2026-05-09 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Freedom Blue Mcr Adv | $107.65 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS CONNELLSVILLE Outpatient | Blue Cross | Complete Blue Mcr Adv | $109.35 | — | — | 2026-05-09 | MRF ↗ |
| PENN HIGHLANDS CONNELLSVILLE Outpatient | Blue Cross | Community Blue Mcr Adv | $109.35 | — | — | 2026-05-09 | MRF ↗ |
| VIRGINIA MASON MEDICAL CENTER Outpatient | Aetna | Medicare Advantage Hmo | $110.40 | — | — | 2026-05-27 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Wellcare | Medicare | $110.64 | — | — | 2026-05-09 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Windsor | Medicare | $110.64 | — | — | 2026-05-09 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Cigna Healthspring | Medicare | $110.64 | — | — | 2026-05-09 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Arkansas Total Care | Medicaid | $112.83 | — | — | 2026-05-09 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Managed Care | $113.31 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Performance Blue | $113.31 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Managed Care | $113.31 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS CONNELLSVILLE Outpatient | Traditional Medicare | Traditional Medicare | $113.31 | — | — | 2026-05-09 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Indemnity | $113.31 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Traditional Medicare | Traditional Medicare | $113.31 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS CONNELLSVILLE Outpatient | Geisinger | Mcr Advantage | $113.31 | — | — | 2026-05-09 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Aca | $113.31 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - All Social Mission | $113.31 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Aca | $113.31 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - My Blue Access Ppo | $113.31 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Traditional Medicare | Traditional Medicare | $113.31 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - All Social Mission | $113.31 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Performance Blue | $113.31 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Indemnity | $113.31 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - My Blue Access Ppo | $113.31 | — | — | 2026-05-14 | MRF ↗ |
| FISHER-TITUS HOSPITAL Outpatient | Perennial Advantage | Perennial Advantage | $113.43 | — | — | 2026-05-27 | MRF ↗ |
| FISHER-TITUS HOSPITAL Outpatient | Optum | Vaccnoptum | $113.43 | — | — | 2026-05-27 | MRF ↗ |
| FISHER-TITUS HOSPITAL Outpatient | Sidecar | Sidecarcommercial | $115.40 | — | — | 2026-05-27 | MRF ↗ |
| INTERMOUNTAIN HEALTH SPANISH FORK HOSPITAL Outpatient | Molina | Medicare Advantage | $115.54 | — | — | 2026-05-15 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Healthy U | Medicaid | $115.54 | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH SPANISH FORK HOSPITAL Outpatient | Humana | Medicare Choice Ppo | $115.54 | — | — | 2026-05-15 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Molina | Medicaid | $115.54 | — | — | 2026-05-14 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Molina | Medicaid | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SPANISH FORK HOSPITAL Outpatient | Molina | Medicare Complete Care Hmo Snp | $115.54 | — | — | 2026-05-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH SPANISH FORK HOSPITAL Outpatient | Uhc | Medicare Advantage | $115.54 | — | — | 2026-05-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Health Partners Of Nevada | Medicare Advantage | $115.54 | — | — | 2026-05-14 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Uhc | Medicare Advantage | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Healthy U | Medicaid | $115.54 | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Selecthealth | Medicare Advantage | $115.54 | — | — | 2026-05-14 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Aetna | Medicare Adv Ppo | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Molina | Medicare Choice Care Hmo | $115.54 | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Aetna | Medicare Adv Hmo | $115.54 | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH SPANISH FORK HOSPITAL Outpatient | Health Partners Of Nevada | Medicare Advantage | $115.54 | — | — | 2026-05-15 | MRF ↗ |
| CABELL HUNTINGTON HOSPITAL, INC Outpatient | Aetna | Medicare | $115.54 | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Humana | Medicare Choice Ppo | $115.54 | — | — | 2026-05-14 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Selecthealth | Medicare Advantage | $115.54 | — | — | 2026-05-14 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Regence Bcbs | Medadvantage Ppo | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Healthy U | Medicaid | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Health Plan Of Nevada | Medicaid | $115.54 | — | — | 2026-05-14 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Health Partners Of Nevada | Medicare Advantage | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | American Health | Medicare Adv Ut Hmo I-Snp | $115.54 | — | — | 2026-05-13 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Health Plan Of Nevada | Medicaid | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Selecthealth | Medicare Advantage | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Selecthealth | Medicaid | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | American Health | Medicare Adv Ut Hmo I-Snp | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Health Partners Of Nevada | Medicare Advantage | $115.54 | — | — | 2026-05-14 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Aetna | Medicare Adv Hmo | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Molina | Medicare Complete Care Hmo Snp | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Molina | Medicare Choice Care Hmo | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| CABELL HUNTINGTON HOSPITAL, INC Outpatient | Humana | Medicare | $115.54 | — | — | 2026-05-14 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Molina | Medicaid | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Humana | Medicare Choice Ppo | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Molina | Medicare Choice Care Hmo | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Healthy U | Medicaid | $115.54 | — | — | 2026-05-13 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Molina | Medicare Complete Care Hmo Snp | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Humana | Medicare Choice Ppo | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Uhc | Medicare Advantage | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Humana | Medicare Choice Ppo | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Aetna | Medicare Adv Hmo | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Aetna | Medicare Adv Ppo | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | American Health | Medicare Adv Ut Hmo I-Snp | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Health Plan Of Nevada | Medicaid | $115.54 | — | — | 2026-05-13 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Uhc | Medicare Advantage | $115.54 | — | — | 2026-05-14 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Southwest Behavioral Health | Behavioral Health | $115.54 | — | — | 2026-05-13 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Selecthealth | Medicaid | $115.54 | — | — | 2026-05-13 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Selecthealth | Medicaid | $115.54 | — | — | 2026-05-14 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | American Health | Medicare Adv Ut Hmo I-Snp | $115.54 | — | — | 2026-05-13 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Uhc | Medicare Advantage | $115.54 | — | — | 2026-05-13 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Molina | Medicare Complete Care Hmo Snp | $115.54 | — | — | 2026-05-14 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Molina | Medicare Choice Care Hmo | $115.54 | — | — | 2026-05-13 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Regence Bcbs | Medadvantage Ppo | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Molina | Medicare Complete Care Hmo Snp | $115.54 | — | — | 2026-05-13 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Molina | Medicare Advantage | $115.54 | — | — | 2026-05-14 | MRF ↗ |
| CABELL HUNTINGTON HOSPITAL, INC Outpatient | Peak Health | Medicare | $115.54 | — | — | 2026-05-14 | MRF ↗ |
| CABELL HUNTINGTON HOSPITAL, INC Outpatient | United Healthcare | Medicare | $115.54 | — | — | 2026-05-14 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Molina | Medicaid | $115.54 | — | — | 2026-05-15 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Molina | Medicare Advantage | $115.54 | — | — | 2026-05-13 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Molina | Medicare Complete Care Hmo Snp | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | American Health | Medicare Adv Ut Hmo I-Snp | $115.54 | — | — | 2026-05-14 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Molina | Medicaid | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Humana | Medicare Choice Ppo | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| CABELL HUNTINGTON HOSPITAL, INC Outpatient | Peia | Other Governmental | $115.54 | — | — | 2026-05-14 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Uhc | Medicare Advantage | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Aetna | Medicare Adv Hmo | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Aetna | Medicare Adv Ppo | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Health Plan Of Nevada | Medicaid | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | American Health | Medicare Adv Ut Hmo I-Snp | $115.54 | — | — | 2026-05-14 | MRF ↗ |
| CABELL HUNTINGTON HOSPITAL, INC Outpatient | Highmark Blue Cross | Medicare | $115.54 | — | — | 2026-05-14 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | American Health | Medicare Adv Ut Hmo I-Snp | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Selecthealth | Medicare Advantage | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Health Plan Of Nevada | Medicaid | $115.54 | — | — | 2026-05-14 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Selecthealth | Medicaid | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Health Plan Of Nevada | Medicaid | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Regence Bcbs | Medadvantage | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Aetna | Medicare Adv Hmo | $115.54 | — | — | 2026-05-14 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Molina | Medicaid | $115.54 | — | — | 2026-05-13 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Health Partners Of Nevada | Medicare Advantage | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Regence Bcbs | Medadvantage Ppo | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Healthy U | Medicaid | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Health Partners Of Nevada | Medicare Advantage | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Regence Bcbs | Medadvantage Ppo | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Selecthealth | Signature Individual Aca | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Selecthealth | Value Individual Aca | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Molina | Medicaid | $115.54 | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Aetna | Medicare Adv Ppo | $115.54 | — | — | 2026-05-14 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Molina | Medicare Complete Care Hmo Snp | $115.54 | — | — | 2026-05-15 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Uhc | Medicare Advantage | $115.54 | — | — | 2026-05-15 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Selecthealth | Med Individual Aca | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SPANISH FORK HOSPITAL Outpatient | Selecthealth | Med Individual Aca | $115.54 | — | — | 2026-05-15 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Selecthealth | Medicare Advantage | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Healthy U | Medicaid | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Aetna | Medicare Adv Ppo | $115.54 | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH SPANISH FORK HOSPITAL Outpatient | Selecthealth | Medicare Advantage | $115.54 | — | — | 2026-05-15 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Selecthealth | Medicaid | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Health Partners Of Nevada | Medicare Advantage | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Uhc | Medicare Advantage | $115.54 | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Regence Bcbs | Medadvantage Ppo | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Health Plan Of Nevada | Medicaid | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SPANISH FORK HOSPITAL Outpatient | Selecthealth | Medicaid | $115.54 | — | — | 2026-05-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH SPANISH FORK HOSPITAL Outpatient | Selecthealth | Signature Individual Aca | $115.54 | — | — | 2026-05-15 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | American Health | Medicare Adv Ut Hmo I-Snp | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Selecthealth | Medicare Advantage | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SPANISH FORK HOSPITAL Outpatient | American Health | Medicare Adv Ut Hmo I-Snp | $115.54 | — | — | 2026-05-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Selecthealth | Medicaid | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Aetna | Medicare Adv Hmo | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SPANISH FORK HOSPITAL Outpatient | Selecthealth | Value Individual Aca | $115.54 | — | — | 2026-05-15 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Aetna | Medicare Adv Ppo | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Uhc | Medicare Advantage | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Molina | Medicare Complete Care Hmo Snp | $115.54 | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | American Health | Medicare Adv Ut Hmo I-Snp | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Humana | Medicare Choice Ppo | $115.54 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Regence Bcbs | Medadvantage Ppo | $115.54 | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH SPANISH FORK HOSPITAL Outpatient | Health Plan Of Nevada | Medicaid | $115.54 | — | — | 2026-05-15 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Molina | Medicare Advantage | $115.54 | — | — | 2026-05-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Aetna | Medicare Adv Ppo | $115.54 | — | — | 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.