3000102 — Cyproheptadine (periactin) 4 Mg Tablet
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). CYPROHEPTADINE (PERIACTIN) 4 MG TABLET (CDM 3000102) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/3000102?code_type=CDM
MLA (9th ed.)
“CYPROHEPTADINE (PERIACTIN) 4 MG TABLET (CDM 3000102) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/3000102?code_type=CDM. Accessed .
Chicago (notes-bibliography)
“CYPROHEPTADINE (PERIACTIN) 4 MG TABLET (CDM 3000102) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/3000102?code_type=CDM.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $2–$86 (25th–75th percentile) across 9 hospitals · 52 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CDM 3000102 — 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 |
|---|---|---|---|---|---|---|---|
| LEVI HOSPITAL OutpatientFacility | NovaSys Health Inc | NovaSys All Payor | $0.32 | $2.25 | $0.83 | 2024-12-26 | MRF ↗ |
| LEVI HOSPITAL OutpatientFacility | NovaSys Health Inc | NovaSys Exchange | $0.32 | $2.25 | $0.83 | 2024-12-26 | MRF ↗ |
| LEVI HOSPITAL OutpatientFacility | NovaSys Health Inc | Network Access | $0.32 | $2.25 | $0.83 | 2024-12-26 | MRF ↗ |
| LEVI HOSPITAL OutpatientFacility | Aetna Behavioral Health Medicare Advantage | Medicare Advantage | $0.52 | $2.25 | $0.83 | 2024-12-26 | MRF ↗ |
| LEVI HOSPITAL OutpatientFacility | BCBS HMO | HMO | $0.90 | $2.25 | $0.83 | 2024-12-26 | MRF ↗ |
| LEVI HOSPITAL OutpatientFacility | BCBS Preferred | Preferred | $0.90 | $2.25 | $0.83 | 2024-12-26 | MRF ↗ |
| LEVI HOSPITAL OutpatientFacility | BCBS PPO | PPO | $0.90 | $2.25 | $0.83 | 2024-12-26 | MRF ↗ |
| LEVI HOSPITAL OutpatientFacility | True Blue PPO | True Blue PPO | $0.90 | $2.25 | $0.83 | 2024-12-26 | MRF ↗ |
| LEVI HOSPITAL OutpatientFacility | BCBS MCR ADV | Health Advantage HMO | $0.94 | $2.25 | $0.83 | 2024-12-26 | MRF ↗ |
| LEVI HOSPITAL OutpatientFacility | Access Health SVCS ADV Medicare Advantage-Superior Select | Medicare Advantage | $0.94 | $2.25 | $0.83 | 2024-12-26 | MRF ↗ |
| LEVI HOSPITAL OutpatientFacility | Cigna Medicare Advantage | Medicare Advantage | $0.94 | $2.25 | $0.83 | 2024-12-26 | MRF ↗ |
| LEVI HOSPITAL OutpatientFacility | Caresource Medicare Behavioral | Medicare Behavorial | $0.94 | $2.25 | $0.83 | 2024-12-26 | MRF ↗ |
| LEVI HOSPITAL OutpatientFacility | Caresouce MarketPlace BH | All Products | $0.94 | $2.25 | $0.83 | 2024-12-26 | MRF ↗ |
| LEVI HOSPITAL OutpatientFacility | Amerigroup Medicare Advantage | Medicare Advantage | $0.94 | $2.25 | $0.83 | 2024-12-26 | MRF ↗ |
| LEVI HOSPITAL OutpatientFacility | Supple,emental | Medicare Advantage | $0.94 | $2.25 | $0.83 | 2024-12-26 | MRF ↗ |
| LEVI HOSPITAL OutpatientFacility | Caresource Medicare | Medicare Advantage | $0.94 | $2.25 | $0.83 | 2024-12-26 | MRF ↗ |
| LEVI HOSPITAL OutpatientFacility | Humana Medicare | Medicare Advantage | $0.94 | $2.25 | $0.83 | 2024-12-26 | MRF ↗ |
| LEVI HOSPITAL OutpatientFacility | NovaSys Health Inc | Medicaid Passe | $0.97 | $2.25 | $0.83 | 2024-12-26 | MRF ↗ |
| LEVI HOSPITAL OutpatientFacility | NovaSys Health Inc | Medicare Advantage | $0.97 | $2.25 | $0.83 | 2024-12-26 | MRF ↗ |
| LEVI HOSPITAL OutpatientFacility | AllWell | Medicare Advantage | $0.97 | $2.25 | $0.83 | 2024-12-26 | MRF ↗ |
| LEVI HOSPITAL OutpatientFacility | Velocity National Provider Network | Workers Comp | $1.24 | $2.25 | $0.83 | 2024-12-26 | MRF ↗ |
| LEVI HOSPITAL BothFacility | Velocity National Provider Network | Auto Liability | $1.24 | $2.25 | $0.83 | 2024-12-26 | MRF ↗ |
| LEVI HOSPITAL OutpatientFacility | Velocity National Provider Network | Group Health | $1.24 | $2.25 | $0.83 | 2024-12-26 | MRF ↗ |
| LEVI HOSPITAL OutpatientFacility | Velocity National Provider Network | Medicare Advantage | $1.24 | $2.25 | $0.83 | 2024-12-26 | MRF ↗ |
| LEVI HOSPITAL OutpatientFacility | United Behavorial Health | All Products | $1.35 | $2.25 | $0.83 | 2024-12-26 | MRF ↗ |
| LEVI HOSPITAL OutpatientFacility | Provider Network of America PNOA | All Products | $1.42 | $2.25 | $0.83 | 2024-12-26 | MRF ↗ |
| LEVI HOSPITAL OutpatientFacility | Municipal Health Benefits MHB | All Products | $1.57 | $2.25 | $0.83 | 2024-12-26 | MRF ↗ |
| LEVI HOSPITAL OutpatientFacility | Bardavon | All Products | $1.57 | $2.25 | $0.83 | 2024-12-26 | MRF ↗ |
| LEVI HOSPITAL OutpatientFacility | Multi Plan | All Products | $1.57 | $2.25 | $0.83 | 2024-12-26 | MRF ↗ |
| LEVI HOSPITAL BothFacility | Velocity National Provider Network | All Other | $1.57 | $2.25 | $0.83 | 2024-12-26 | MRF ↗ |
| LEVI HOSPITAL OutpatientFacility | Mercy Behavorial Health | All Products | $1.57 | $2.25 | $0.83 | 2024-12-26 | MRF ↗ |
| LEVI HOSPITAL BothFacility | Corvel | All Products | $1.91 | $2.25 | $0.83 | 2024-12-26 | MRF ↗ |
| MULESHOE AREA MEDICAL CENTER Both | Aetna | Commercial | $2.00 | $5.00 | $3.00 | 2025-12-16 | MRF ↗ |
| MULESHOE AREA MEDICAL CENTER Both | Superior Health Plan | HMO | $3.00 | $5.00 | $3.00 | 2025-12-16 | MRF ↗ |
| MULESHOE AREA MEDICAL CENTER Both | Superior Health Plan | PPO | $3.00 | $5.00 | $3.00 | 2025-12-16 | MRF ↗ |
| MULESHOE AREA MEDICAL CENTER Both | Blue Cross Blue Shield of Texas | Blue Essentials | $4.00 | $5.00 | $3.00 | 2025-12-16 | MRF ↗ |
| MULESHOE AREA MEDICAL CENTER Both | Blue Cross Blue Shield of Texas | Commercial | $4.00 | $5.00 | $3.00 | 2025-12-16 | MRF ↗ |
| MULESHOE AREA MEDICAL CENTER Both | Blue Cross Blue Shield of Texas | HMO | $4.00 | $5.00 | $3.00 | 2025-12-16 | MRF ↗ |
| MULESHOE AREA MEDICAL CENTER Both | Superior Health Plan | Commercial | $5.00 | $5.00 | $3.00 | 2025-12-16 | MRF ↗ |
| WASHINGTON COUNTY HOSPITAL Both | Blue Cross Blue Shield AL | PPO | — | $180.00 | $72.00 | 2025-04-21 | MRF ↗ |
| WASHINGTON COUNTY HOSPITAL Both | United Health Care | PPO | — | $180.00 | $72.00 | 2025-05-21 | MRF ↗ |
| WASHINGTON COUNTY HOSPITAL Both | Blue Cross Blue Shield AL | PPO | — | $180.00 | $72.00 | 2025-05-21 | MRF ↗ |
| WASHINGTON COUNTY HOSPITAL Both | United Health Care | PPO | — | $180.00 | $72.00 | 2025-04-21 | MRF ↗ |
| WASHINGTON COUNTY HOSPITAL Both | Humana | PPO | — | $180.00 | $72.00 | 2025-04-21 | MRF ↗ |
| WASHINGTON COUNTY HOSPITAL Both | Humana | PPO | — | $180.00 | $72.00 | 2025-05-21 | MRF ↗ |
| KNOX COUNTY HOSPITAL Both | Superior Health Plan | Commercial | $18.00 | $29.00 | $29.00 | 2025-11-06 | MRF ↗ |
| KNOX COUNTY HOSPITAL Both | Humana | Commercial | $18.00 | $29.00 | $29.00 | 2025-11-06 | MRF ↗ |
| KNOX COUNTY HOSPITAL Both | MultiPlan | Commercial | $18.00 | $29.00 | $29.00 | 2025-11-06 | MRF ↗ |
| KNOX COUNTY HOSPITAL Both | WellMed | Commercial | $18.00 | $29.00 | $29.00 | 2025-11-06 | MRF ↗ |
| KNOX COUNTY HOSPITAL Both | Blue Cross Blue Shield of Texas | PPO | $20.00 | $29.00 | $29.00 | 2025-11-06 | MRF ↗ |
| KNOX COUNTY HOSPITAL Both | Blue Cross Blue Shield of Texas | Blue Essentials | $20.00 | $29.00 | $29.00 | 2025-11-06 | MRF ↗ |
| KNOX COUNTY HOSPITAL Both | Aetna | Commercial | $23.00 | $29.00 | $29.00 | 2025-11-06 | MRF ↗ |
| KNOX COUNTY HOSPITAL Both | FirstCare | Commercial | $25.00 | $29.00 | $29.00 | 2025-11-06 | MRF ↗ |
| STAR VALLEY MEDICAL CENTER OutpatientFacility | Multiplan | Medicare/VA | $39.89 | $73.67 | $51.57 | 2024-11-12 | MRF ↗ |
| STAR VALLEY MEDICAL CENTER OutpatientFacility | TriWest | Veterans Administration | $41.99 | $73.67 | $51.57 | 2024-11-12 | MRF ↗ |
| STAR VALLEY MEDICAL CENTER OutpatientFacility | United Healthcare | Medicare | $41.99 | $73.67 | $51.57 | 2024-11-12 | MRF ↗ |
| STAR VALLEY MEDICAL CENTER OutpatientFacility | Government Employees Health Association (GEHA) | Medicare | $41.99 | $73.67 | $51.57 | 2024-11-12 | MRF ↗ |
| STAR VALLEY MEDICAL CENTER InpatientFacility | Multiplan | Medicare/VA | $42.69 | $73.67 | $51.57 | 2024-11-12 | MRF ↗ |
| STAR VALLEY MEDICAL CENTER InpatientFacility | United Healthcare | Medicare | $44.94 | $73.67 | $51.57 | 2024-11-12 | MRF ↗ |
| STAR VALLEY MEDICAL CENTER InpatientFacility | Government Employees Health Association (GEHA) | Medicare | $44.94 | $73.67 | $51.57 | 2024-11-12 | MRF ↗ |
| STAR VALLEY MEDICAL CENTER InpatientFacility | TriWest | Veterans Administration | $44.94 | $73.67 | $51.57 | 2024-11-12 | MRF ↗ |
| STAR VALLEY MEDICAL CENTER InpatientFacility | Aetna of WY | Medicare | $47.15 | $73.67 | $51.57 | 2024-11-12 | MRF ↗ |
| STAR VALLEY MEDICAL CENTER OutpatientFacility | Aetna of WY | Medicare | $48.62 | $73.67 | $51.57 | 2024-11-12 | MRF ↗ |
| STAR VALLEY MEDICAL CENTER InpatientFacility | Three Rivers | PPO | $55.25 | $73.67 | $51.57 | 2024-11-12 | MRF ↗ |
| STAR VALLEY MEDICAL CENTER InpatientFacility | PacificSource | Commercial | $66.30 | $73.67 | $51.57 | 2024-11-12 | MRF ↗ |
| ASCENSION VIA CHRISTI HOSPITAL MANHATTAN, INC Outpatient | AETNA | 780_MHKS AETNA 20240701 | $66.42 | $123.00 | $49.20 | 2026-01-01 | MRF ↗ |
| WAMEGO HEALTH CENTER Outpatient | UNITED HEALTHCARE EXCHANGE | 863_WHKS UNITED HEALTHCARE EXCHANGE OUTPATIENT 20250101 | $66.60 | $185.00 | $74.00 | 2026-01-01 | MRF ↗ |
| WAMEGO HEALTH CENTER Outpatient | AMBETTER | 702_AMBETTER MEDICARE OUTPATIENT WHKS 20230601 | $66.60 | $185.00 | $74.00 | 2026-01-01 | MRF ↗ |
| WAMEGO HEALTH CENTER Outpatient | MEDICARE ADVANTAGE UNITED HEALTH CARE | 721_WHKS MEDICARE ADVANTAGE UNITED HEALTHCARE OUTPATIENT 20240101 | $66.60 | $185.00 | $74.00 | 2026-01-01 | MRF ↗ |
| ASCENSION VIA CHRISTI HOSPITAL MANHATTAN, INC Outpatient | CORE SOURCE | 283_CORE SOURCE 20180101 | $67.65 | $123.00 | $49.20 | 2026-01-01 | MRF ↗ |
| ASCENSION VIA CHRISTI HOSPITAL MANHATTAN, INC Outpatient | FIRST HEALTH | 115_FIRST HEALTH 20130101 | $67.65 | $123.00 | $49.20 | 2026-01-01 | MRF ↗ |
| ASCENSION VIA CHRISTI HOSPITAL MANHATTAN, INC Outpatient | COVENTRY | 669_MHKS COVENTRY 20170101 | $67.65 | $123.00 | $49.20 | 2026-01-01 | MRF ↗ |
| WAMEGO HEALTH CENTER Outpatient | MEDICARE ADVANTAGE ALLWELL | 664_WHKS CRITICAL ACCESS HOSPITAL MEDICARE ADVANTAGE ALLWELL OUTPATIENT 20230601 | $68.45 | $185.00 | $74.00 | 2026-01-01 | MRF ↗ |
| STAR VALLEY MEDICAL CENTER InpatientFacility | WINHealth Partners | Commercial | $69.99 | $73.67 | $51.57 | 2024-11-12 | MRF ↗ |
| STAR VALLEY MEDICAL CENTER InpatientFacility | Government Employees Health Association (GEHA) | Commercial | $69.99 | $73.67 | $51.57 | 2024-11-12 | MRF ↗ |
| STAR VALLEY MEDICAL CENTER InpatientFacility | Entrust | Commercial | $69.99 | $73.67 | $51.57 | 2024-11-12 | MRF ↗ |
| STAR VALLEY MEDICAL CENTER InpatientFacility | Wise Provider Network | Commercial | $69.99 | $73.67 | $51.57 | 2024-11-12 | MRF ↗ |
| STAR VALLEY MEDICAL CENTER InpatientFacility | First Choice Health | Commercial | $69.99 | $73.67 | $51.57 | 2024-11-12 | MRF ↗ |
| STAR VALLEY MEDICAL CENTER InpatientFacility | United Healthcare | Commercial | $70.35 | $73.67 | $51.57 | 2024-11-12 | MRF ↗ |
| STAR VALLEY MEDICAL CENTER InpatientFacility | Altius | Commercial | $70.72 | $73.67 | $51.57 | 2024-11-12 | MRF ↗ |
| STAR VALLEY MEDICAL CENTER InpatientFacility | Idaho Integrated Healthcare | Commercial | $71.46 | $73.67 | $51.57 | 2024-11-12 | MRF ↗ |
| STAR VALLEY MEDICAL CENTER InpatientFacility | Blue Cross Blue Shield of Wyoming | Commercial | $71.46 | $73.67 | $51.57 | 2024-11-12 | MRF ↗ |
| STAR VALLEY MEDICAL CENTER InpatientFacility | ChoiceCare Network | Commercial | $71.46 | $73.67 | $51.57 | 2024-11-12 | MRF ↗ |
| STAR VALLEY MEDICAL CENTER InpatientFacility | Aetna of WY | Commercial/Medical Rental | $72.20 | $73.67 | $51.57 | 2024-11-12 | MRF ↗ |
| STAR VALLEY MEDICAL CENTER InpatientFacility | PHCS | PPO | $72.20 | $73.67 | $51.57 | 2024-11-12 | MRF ↗ |
| STAR VALLEY MEDICAL CENTER InpatientFacility | Beech Street | Commercial | $72.20 | $73.67 | $51.57 | 2024-11-12 | MRF ↗ |
| STAR VALLEY MEDICAL CENTER OutpatientFacility | WINHealth Partners | Commercial | $72.20 | $73.67 | $51.57 | 2024-11-12 | MRF ↗ |
| STAR VALLEY MEDICAL CENTER InpatientFacility | One Health Plan of WY | PPO | $72.20 | $73.67 | $51.57 | 2024-11-12 | MRF ↗ |
| STAR VALLEY MEDICAL CENTER InpatientFacility | Cigna of WY | Commercial | $72.20 | $73.67 | $51.57 | 2024-11-12 | MRF ↗ |
| STAR VALLEY MEDICAL CENTER InpatientFacility | HealthUtah | PPO | $73.67 | $73.67 | $51.57 | 2024-11-12 | MRF ↗ |
| ASCENSION VIA CHRISTI HOSPITAL MANHATTAN, INC Outpatient | MEDICA | 799_MEDICA HEALTHIER YOU 20241001 | $78.72 | $123.00 | $49.20 | 2026-01-01 | MRF ↗ |
| WAMEGO HEALTH CENTER Both | SMARTHEALTH | 651_WHKS SMARTHEALTH OUTPATIENT 20230101 | $81.40 | $185.00 | $74.00 | 2026-01-01 | MRF ↗ |
| ASCENSION VIA CHRISTI HOSPITAL MANHATTAN, INC Outpatient | UHC | 844_MHKS UNITED HEALTH CARE 20250101 | $89.79 | $123.00 | $49.20 | 2026-01-01 | MRF ↗ |
| ASCENSION VIA CHRISTI HOSPITAL MANHATTAN, INC Outpatient | MULTIPLAN | 106_MULTIPLAN PHCS MHKS 20180601 | $98.40 | $123.00 | $49.20 | 2026-01-01 | MRF ↗ |
| WAMEGO HEALTH CENTER Outpatient | CORE SOURCE | 283_CORE SOURCE 20180101 | $101.75 | $185.00 | $74.00 | 2026-01-01 | MRF ↗ |
| WAMEGO HEALTH CENTER Outpatient | FIRST HEALTH | 115_FIRST HEALTH 20130101 | $101.75 | $185.00 | $74.00 | 2026-01-01 | MRF ↗ |
| ASCENSION VIA CHRISTI HOSPITAL MANHATTAN, INC Outpatient | CENTURY | 668_CENTURY 20130101 | $108.24 | $123.00 | $49.20 | 2026-01-01 | MRF ↗ |
| ASCENSION VIA CHRISTI HOSPITAL MANHATTAN, INC Outpatient | CIGNA | 778_MHKS CIGNA 20240701 | $109.47 | $123.00 | $49.20 | 2026-01-01 | MRF ↗ |
| ASCENSION VIA CHRISTI HOSPITAL MANHATTAN, INC Both | HUMANA | 870_HUMANA 20250101 | $110.70 | $123.00 | $49.20 | 2026-01-01 | MRF ↗ |
| WAMEGO HEALTH CENTER Outpatient | MEDICA | 799_MEDICA HEALTHIER YOU 20241001 | $118.40 | $185.00 | $74.00 | 2026-01-01 | MRF ↗ |
| ASCENSION VIA CHRISTI HOSPITAL MANHATTAN, INC Both | CDM DEFAULT - NON-NEGOTIATED RATE | CDM DEFAULT - NON-NEGOTIATED RATE | $123.00 | $123.00 | $49.20 | 2026-01-01 | MRF ↗ |
| ASCENSION VIA CHRISTI HOSPITAL MANHATTAN, INC Outpatient | NON-CONTRACTED | 275_NON-CONTRACTED 20170101 | $123.00 | $123.00 | $49.20 | 2026-01-01 | MRF ↗ |
| FOREST HEALTH MEDICAL CENTER Both | — | — | — | $128.76 | — | 2026-02-26 | MRF ↗ |
| WAMEGO HEALTH CENTER Outpatient | UHC | 845_WHKS UNITED HEALTH CARE 20240701 | $133.20 | $185.00 | $74.00 | 2026-01-01 | MRF ↗ |
| WAMEGO HEALTH CENTER Outpatient | CENTURY | 668_CENTURY 20130101 | $162.80 | $185.00 | $74.00 | 2026-01-01 | MRF ↗ |
| WAMEGO HEALTH CENTER Outpatient | AETNA | 781_WHKS AETNA 20240701 | $162.80 | $185.00 | $74.00 | 2026-01-01 | MRF ↗ |
| WAMEGO HEALTH CENTER Outpatient | CIGNA | 779_WHKS CIGNA CAH 20240701 | $164.65 | $185.00 | $74.00 | 2026-01-01 | MRF ↗ |
| WAMEGO HEALTH CENTER Outpatient | COVENTRY | 670_WHKS COVENTRY 20170101 | $166.50 | $185.00 | $74.00 | 2026-01-01 | MRF ↗ |
| WAMEGO HEALTH CENTER Outpatient | MULTIPLAN | 625_MULTIPLAN PHCS WHKS 20180601 | $166.50 | $185.00 | $74.00 | 2026-01-01 | MRF ↗ |
| WAMEGO HEALTH CENTER Both | HUMANA | 870_HUMANA 20250101 | $166.50 | $185.00 | $74.00 | 2026-01-01 | MRF ↗ |
| WASHINGTON COUNTY HOSPITAL Both | Alabama Medicaid | PPO | $180.00 | $180.00 | $72.00 | 2025-04-21 | MRF ↗ |
| WASHINGTON COUNTY HOSPITAL Both | Alabama Medicaid | PPO | $180.00 | $180.00 | $72.00 | 2025-05-21 | MRF ↗ |
| WAMEGO HEALTH CENTER Outpatient | NON-CONTRACTED | 275_NON-CONTRACTED 20170101 | $185.00 | $185.00 | $74.00 | 2026-01-01 | MRF ↗ |
| WAMEGO HEALTH CENTER Both | CDM DEFAULT - NON-NEGOTIATED RATE | CDM DEFAULT - NON-NEGOTIATED RATE | $185.00 | $185.00 | $74.00 | 2026-01-01 | MRF ↗ |
| PARKVIEW HOSPITAL Both | FirstCare | PPO | $452.00 | $3,766.00 | $3,201.00 | 2026-08-20 | MRF ↗ |
| PARKVIEW HOSPITAL Both | Blue Cross Blue Shield | HMO | $2,260.00 | $3,766.00 | $3,201.00 | 2026-08-20 | MRF ↗ |
| PARKVIEW HOSPITAL Both | Aetna | Commercial | $3,201.00 | $3,766.00 | $3,201.00 | 2026-08-20 | MRF ↗ |
| PARKVIEW HOSPITAL Both | United Healthcare | Commercial | $3,212.00 | $3,766.00 | $3,201.00 | 2026-08-20 | MRF ↗ |
| PARKVIEW HOSPITAL Both | Blue Cross Blue Shield | PPO | $3,389.00 | $3,766.00 | $3,201.00 | 2026-08-20 | MRF ↗ |
| PARKVIEW HOSPITAL Both | Humana | Medicare Advantage | $3,465.00 | $3,766.00 | $3,201.00 | 2026-08-20 | MRF ↗ |
| PARKVIEW HOSPITAL Both | Blue Cross Blue Shield | Medicare Advantage | $3,465.00 | $3,766.00 | $3,201.00 | 2026-08-20 | MRF ↗ |
| PARKVIEW HOSPITAL Both | Superior HealthPlan | Medicare Advantage | $3,465.00 | $3,766.00 | $3,201.00 | 2026-08-20 | MRF ↗ |
| PARKVIEW HOSPITAL Both | FirstCare | HMO | $3,578.00 | $3,766.00 | $3,201.00 | 2026-08-20 | MRF ↗ |