31834 — Burr Xo Trc 31-12930c
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). BURR XO TRC 31-12930C (CDM 31834) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/31834?code_type=CDM
MLA (9th ed.)
“BURR XO TRC 31-12930C (CDM 31834) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/31834?code_type=CDM. Accessed .
Chicago (notes-bibliography)
“BURR XO TRC 31-12930C (CDM 31834) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/31834?code_type=CDM.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $21–$82 (25th–75th percentile) across 7 hospitals · 55 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CDM 31834 — 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 |
|---|---|---|---|---|---|---|---|
| METHODIST HOSPITAL Outpatient | Superior Health | STARPLUS | $6.54 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Superior Health | CHIP | $6.54 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Superior Health | STARKids | $6.54 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Superior Health | CHPFC | $6.54 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Superior Health | STAR | $6.54 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | BCBS | Cap | $10.40 | $72.22 | $72.22 | 2026-03-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | BCBS | BlueChoice | $10.40 | $72.22 | $72.22 | 2026-03-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | United | OptionsPPO | $10.91 | $72.22 | $72.22 | 2026-03-01 | MRF ↗ |
| WESLEY MEDICAL CENTER Outpatient | United | OptionsPPO | $11.15 | $69.24 | $69.24 | 2024-10-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | Health Partners of Kansas | CignaLocalPlusNetwork | $12.49 | $72.22 | $72.22 | 2026-03-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | WPPA | ProviderCareNetwork | $12.57 | $72.22 | $72.22 | 2026-03-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | WPPA | UnifiedHealth | $12.57 | $72.22 | $72.22 | 2026-03-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | WPPA | WPPAPrimeNetwork | $12.57 | $72.22 | $72.22 | 2026-03-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | Aetna | LocalPreferred | $12.58 | $72.22 | $72.22 | 2026-03-01 | MRF ↗ |
| WESLEY MEDICAL CENTER Outpatient | Health Partners of Kansas | CignaLocalPlusNetwork | $12.95 | $69.24 | $69.24 | 2024-10-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | Centene | HIX | $13.00 | $72.22 | $72.22 | 2026-03-01 | MRF ↗ |
| WESLEY MEDICAL CENTER Outpatient | WPPA | PrimeNetwork | $13.22 | $69.24 | $69.24 | 2024-10-01 | MRF ↗ |
| WESLEY MEDICAL CENTER Outpatient | WPPA | ProviderCareNetwork | $13.22 | $69.24 | $69.24 | 2024-10-01 | MRF ↗ |
| WESLEY MEDICAL CENTER Outpatient | WPPA | UnifiedHealthPlan | $13.22 | $69.24 | $69.24 | 2024-10-01 | MRF ↗ |
| WESLEY MEDICAL CENTER Outpatient | Aetna | LocalPreferred | $13.25 | $69.24 | $69.24 | 2024-10-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | Medical Associates Health Plan | COMM | $13.65 | $72.22 | $72.22 | 2026-03-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | Preferred Health Choices | COMM | $13.65 | $72.22 | $72.22 | 2026-03-01 | MRF ↗ |
| WESLEY MEDICAL CENTER Outpatient | Centene | COMM | $13.85 | $69.24 | $69.24 | 2024-10-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Amerigroup | CHIP | $15.26 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Amerigroup | MCDBH | $15.26 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Amerigroup | MCD | $15.26 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Community First | MCDSTAR | $15.26 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Community First | CHIP | $15.26 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Amerigroup | CHIPBH | $15.26 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| WESLEY MEDICAL CENTER Outpatient | Health Partners of Kansas | Non-LocalPlusandNon-ConnectCare | $16.89 | $69.24 | $69.24 | 2024-10-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | Aetna | LocalOpen | $16.93 | $72.22 | $72.22 | 2026-03-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | Health Partners of Kansas | Non-LocalPlusandNon-ConnectCare | $17.04 | $72.22 | $72.22 | 2026-03-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | Aetna | NationalOpen | $17.33 | $72.22 | $72.22 | 2026-03-01 | MRF ↗ |
| WESLEY MEDICAL CENTER Outpatient | Aetna | LocalOpen | $17.84 | $69.24 | $69.24 | 2024-10-01 | MRF ↗ |
| WESLEY MEDICAL CENTER Outpatient | Aetna | NationalOpen | $18.26 | $69.24 | $69.24 | 2024-10-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Imperial Insurance | MCRSNP | $20.71 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Imperial Insurance | MCRPFFS | $20.71 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Imperial Insurance | MCRHMO | $20.71 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Imperial Insurance | MCRPOS | $20.71 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Imperial Insurance | DualEligible | $20.71 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Imperial Insurance | MCRPPO | $20.71 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| WESLEY MEDICAL CENTER Outpatient | Aetna Better Health | MCD | $20.77 | $69.24 | $69.24 | 2024-10-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | Aetna Better Health | MCD | $21.67 | $72.22 | $72.22 | 2026-03-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Oscar | PPO | $21.80 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Oscar | POS | $21.80 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Oscar | EPO | $21.80 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Oscar | BroadNetworkHIX | $21.80 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | Spirit Aerosystems | COMMOON | $23.11 | $72.22 | $72.22 | 2026-03-01 | MRF ↗ |
| WESLEY MEDICAL CENTER Outpatient | Spirit Aerosystems | COMMOON | $23.40 | $69.24 | $69.24 | 2024-10-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | Aetna | Spirit | $25.78 | $72.22 | $72.22 | 2026-03-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Molina | QHP | $27.25 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | United | OptionsPPO | $28.12 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Aetna | QHPHIX | $29.10 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| WESLEY MEDICAL CENTER Outpatient | United | GlobalBenefitPlan | $31.16 | $69.24 | $69.24 | 2024-10-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Cigna | NBN | $32.37 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | United | GlobalBenefitPlan | $32.50 | $72.22 | $72.22 | 2026-03-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | First Health | PPO | $33.29 | $72.22 | $72.22 | 2026-03-01 | MRF ↗ |
| WESLEY MEDICAL CENTER Outpatient | First Health | PPO | $33.58 | $69.24 | $69.24 | 2024-10-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Community First Health Plans | COMM | $33.79 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Cigna Lifesource | COMM | $33.79 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | BCBS | MBH | $33.90 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Healthcare Highways | NarrowNetwork | $34.23 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| WESLEY MEDICAL CENTER Outpatient | Health Partners of Kansas | Humana | $34.62 | $69.24 | $69.24 | 2024-10-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | BCBS | TRAD | $34.77 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Focus Health Solutions | COMM | $34.88 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | Health Partners of Kansas | Humana | $36.11 | $72.22 | $72.22 | 2026-03-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Cigna | OpenAccessPlus | $36.30 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Humana | PPO | $36.65 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Humana | HMO | $36.65 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Superior | AmbetterValueHMO | $38.15 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Valenz | COMM | $38.15 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Aetna | NarrowNetwork | $39.68 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | BCBS | HPN | $40.98 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | BCBS | EPO | $40.98 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | BCBS | BAV | $41.09 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Evry Health | Broad | $41.20 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Superior | AmbetterHMO | $41.42 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Superior | AmbetterEPO | $41.42 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Aetna | NewBusinessRates | $42.62 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Aetna | CommercialBaseNetwork | $43.93 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Cigna | PPO | $43.93 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| WESLEY MEDICAL CENTER Outpatient | Triwest Healthcare Alliance | Tricare | $45.01 | $69.24 | $69.24 | 2024-10-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | Triwest Healthcare Alliance | Tricare | $46.94 | $72.22 | $72.22 | 2026-03-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | First Health | COMM | $48.40 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| WESLEY MEDICAL CENTER Outpatient | Multiplan | COMMPPOPRIMARYNETWORK | $48.47 | $69.24 | $69.24 | 2024-10-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Fidelis SecureCare | MGMCR | $49.05 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | BCBS | HMO | $49.81 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | Multiplan | COMMPPOPRIMARYNETWORK | $50.55 | $72.22 | $72.22 | 2026-03-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Aetna | OON | $51.56 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | BCBS | EPOSOA | $52.10 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Emerging Therapy Solutions | MCR | $52.32 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | BCBS | PPO | $54.28 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Texas Healthcare Foundation HEB | HEBEmployee | $54.50 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | National ChoiceCare | WORKERSCOMP | $54.50 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | TX Healthcare Foundation | PPO | $54.50 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Aetna | ASA | $55.81 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| WESLEY MEDICAL CENTER Outpatient | USA Managed Care | COMM | $58.85 | $69.24 | $69.24 | 2024-10-01 | MRF ↗ |
| WESLEY MEDICAL CENTER Outpatient | Multiplan | COMMPPOCOMPLEMENTARYNETWORK | $58.85 | $69.24 | $69.24 | 2024-10-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | HealthSmart Preferred Care | Accel | $59.95 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Physician Cooperative of Texas | WORKERSCOMP | $59.95 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Independent Medical Systems | PPO | $59.95 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | Multiplan | COMMPPOCOMPLEMENTARYNETWORK | $61.39 | $72.22 | $72.22 | 2026-03-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | USA Managed Care | COMM | $61.39 | $72.22 | $72.22 | 2026-03-01 | MRF ↗ |
| WESLEY MEDICAL CENTER Outpatient | Multiplan | BeechStreetCOMMPPO | $62.32 | $69.24 | $69.24 | 2024-10-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | Multiplan | BeechStreetCOMMPPO | $65.00 | $72.22 | $72.22 | 2026-03-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | HAA Preferred Partners | LOGOV | $65.40 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | San Antonio Employers Health Alliance | PPO | $65.40 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | National Healthcare Solutions | PPO | $70.85 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Coastal Comp Health Networks | WORKERSCOMP | $70.85 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | PHCS | PrimaryPPO | $73.03 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | MultiPlan, Inc. | PRIMARYPPO | $73.03 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | TML Intergovernmental EBP | PPO | $76.30 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Emerging Therapy Solutions | COMM | $78.48 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | TriWest Health Alliance | TRICARE | $81.75 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | MultiPlan, Inc. | COMPLEMENTARYPPO | $81.75 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | TriWest VA PCCC | FEDERAL | $81.75 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | PHCS | Complimentary | $81.75 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | United Payors United Providers | PPO | $87.20 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Admar Corporation | EPO | $87.20 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | DirectCare America | PPO | $87.20 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Blue Bell | PPO | $87.20 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | USA Managed Care | PPO | $87.20 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Admar Corporation | PPO | $87.20 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Galaxy Health Network | COMM | $92.65 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Managed Healthcare | PPO | $92.65 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | MedicalControl | PPO | $92.65 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| ASCENSION VIA CHRISTI HOSPITAL MANHATTAN, INC Both | SMARTHEALTH | 794_MHKS SMARTHEALTH INPATIENT 20241001 | $102.96 | $264.00 | $105.60 | 2026-01-01 | MRF ↗ |
| ASCENSION VIA CHRISTI HOSPITAL MANHATTAN, INC Both | SMARTHEALTH | 655_MHKS SMARTHEALTH OUTPATIENT 20230101 | $102.96 | $264.00 | $105.60 | 2026-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Optum | MCD | $109.00 | $109.00 | $109.00 | 2025-01-01 | MRF ↗ |
| ASCENSION VIA CHRISTI HOSPITAL MANHATTAN, INC Outpatient | AETNA | 780_MHKS AETNA 20240701 | $142.56 | $264.00 | $105.60 | 2026-01-01 | MRF ↗ |
| ASCENSION VIA CHRISTI HOSPITAL MANHATTAN, INC Outpatient | FIRST HEALTH | 115_FIRST HEALTH 20130101 | $145.20 | $264.00 | $105.60 | 2026-01-01 | MRF ↗ |
| ASCENSION VIA CHRISTI HOSPITAL MANHATTAN, INC Outpatient | COVENTRY | 669_MHKS COVENTRY 20170101 | $145.20 | $264.00 | $105.60 | 2026-01-01 | MRF ↗ |
| ASCENSION VIA CHRISTI HOSPITAL MANHATTAN, INC Outpatient | CORE SOURCE | 283_CORE SOURCE 20180101 | $145.20 | $264.00 | $105.60 | 2026-01-01 | MRF ↗ |
| ASCENSION VIA CHRISTI HOSPITAL MANHATTAN, INC Outpatient | MEDICA | 799_MEDICA HEALTHIER YOU 20241001 | $168.96 | $264.00 | $105.60 | 2026-01-01 | MRF ↗ |
| ASCENSION VIA CHRISTI HOSPITAL MANHATTAN, INC Outpatient | PROVIDRS CARE | 867_MHKS PROVIDRS CARE 20250701 | $179.52 | $264.00 | $105.60 | 2026-01-01 | MRF ↗ |
| ASCENSION VIA CHRISTI HOSPITAL MANHATTAN, INC Outpatient | UHC | 844_MHKS UNITED HEALTH CARE 20250101 | $192.72 | $264.00 | $105.60 | 2026-01-01 | MRF ↗ |
| ASCENSION VIA CHRISTI HOSPITAL MANHATTAN, INC Outpatient | MULTIPLAN | 106_MULTIPLAN PHCS MHKS 20180601 | $211.20 | $264.00 | $105.60 | 2026-01-01 | MRF ↗ |
| ASCENSION VIA CHRISTI HOSPITAL MANHATTAN, INC Outpatient | CENTURY | 668_CENTURY 20130101 | $232.32 | $264.00 | $105.60 | 2026-01-01 | MRF ↗ |
| ASCENSION VIA CHRISTI HOSPITAL MANHATTAN, INC Outpatient | CIGNA | 778_MHKS CIGNA 20240701 | $234.96 | $264.00 | $105.60 | 2026-01-01 | MRF ↗ |
| ASCENSION VIA CHRISTI HOSPITAL MANHATTAN, INC Both | HUMANA | 870_HUMANA 20250101 | $237.60 | $264.00 | $105.60 | 2026-01-01 | MRF ↗ |
| ASCENSION VIA CHRISTI HOSPITAL MANHATTAN, INC Outpatient | BCBS CHOICE | 843_BLUE CROSS BLUE SHIELD CHOICE MHKS 20250101 | $237.60 | $264.00 | $105.60 | 2026-01-01 | MRF ↗ |
| ASCENSION VIA CHRISTI HOSPITAL MANHATTAN, INC Outpatient | BCBS CAP | 842_BLUE CROSS BLUE SHIELD CAP MHKS 20250101 | $237.60 | $264.00 | $105.60 | 2026-01-01 | MRF ↗ |
| ASCENSION VIA CHRISTI HOSPITAL MANHATTAN, INC Both | CDM DEFAULT - NON-NEGOTIATED RATE | CDM DEFAULT - NON-NEGOTIATED RATE | $264.00 | $264.00 | $105.60 | 2026-01-01 | MRF ↗ |
| ASCENSION VIA CHRISTI HOSPITAL MANHATTAN, INC Outpatient | NON-CONTRACTED | 275_NON-CONTRACTED 20170101 | $264.00 | $264.00 | $105.60 | 2026-01-01 | MRF ↗ |
| SARATOGA HOSPITAL BothFacility | — | — | — | $598.12 | $299.06 | 2025-01-01 | MRF ↗ |
| GLENS FALLS HOSPITAL BothFacility | — | — | — | $598.12 | $299.06 | 2025-01-01 | MRF ↗ |
| MACON COUNTY SAMARITAN MEMORIAL HOSPITAL Outpatient | Ambetter | Commercial | $7,208.00 | $15,982.00 | $12,786.00 | 2026-06-22 | MRF ↗ |
| MACON COUNTY SAMARITAN MEMORIAL HOSPITAL Outpatient | Healthscope | Commercial | $9,589.00 | $15,982.00 | $12,786.00 | 2026-06-22 | MRF ↗ |
| MACON COUNTY SAMARITAN MEMORIAL HOSPITAL Outpatient | Anthem | Commercial | $12,178.00 | $15,982.00 | $12,786.00 | 2026-06-22 | MRF ↗ |
| MACON COUNTY SAMARITAN MEMORIAL HOSPITAL Outpatient | Humana | Commercial | $12,306.00 | $15,982.00 | $12,786.00 | 2026-06-22 | MRF ↗ |
| MACON COUNTY SAMARITAN MEMORIAL HOSPITAL Outpatient | MultiPlan | Commercial | $12,786.00 | $15,982.00 | $12,786.00 | 2026-06-22 | MRF ↗ |
| MACON COUNTY SAMARITAN MEMORIAL HOSPITAL Outpatient | Centene | Commercial | $15,982.00 | $15,982.00 | $12,786.00 | 2026-06-22 | MRF ↗ |