339426 — Loop Cutter Disp 230cm
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). LOOP CUTTER DISP 230CM (CDM 339426) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/339426?code_type=CDM
MLA (9th ed.)
“LOOP CUTTER DISP 230CM (CDM 339426) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/339426?code_type=CDM. Accessed .
Chicago (notes-bibliography)
“LOOP CUTTER DISP 230CM (CDM 339426) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/339426?code_type=CDM.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $2,562–$6,168 (25th–75th percentile) across 4 hospitals · 48 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CDM 339426 — 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 |
|---|---|---|---|---|---|---|---|
| ST MARK'S HOSPITAL Outpatient | ELAP | COMM | $1,261.48 | $5,956.00 | $5,956.00 | 2024-10-01 | MRF ↗ |
| CACHE VALLEY HOSPITAL Outpatient | ELAP | COMM | $1,441.09 | $6,999.00 | $6,999.00 | 2026-03-01 | MRF ↗ |
| ST MARK'S HOSPITAL Outpatient | Sterling Life Insurance | MCR | $1,489.00 | $5,956.00 | $5,956.00 | 2024-10-01 | MRF ↗ |
| ST MARK'S HOSPITAL Outpatient | Cigna | IFPLP | $1,518.78 | $5,956.00 | $5,956.00 | 2024-10-01 | MRF ↗ |
| BRIGHAM CITY COMMUNITY HOSPITAL Outpatient | ELAP | COMM | $1,607.46 | $7,807.00 | $7,807.00 | 2026-03-01 | MRF ↗ |
| ST MARK'S HOSPITAL Outpatient | PEHP | Exclusive | $1,643.86 | $5,956.00 | $5,956.00 | 2024-10-01 | MRF ↗ |
| ST MARK'S HOSPITAL Outpatient | Bright Health | HIX | $1,667.68 | $5,956.00 | $5,956.00 | 2024-10-01 | MRF ↗ |
| CACHE VALLEY HOSPITAL Outpatient | Cigna | IFPLP | $1,714.76 | $6,999.00 | $6,999.00 | 2026-03-01 | MRF ↗ |
| ST MARK'S HOSPITAL Outpatient | Cigna | OAPNBN | $1,715.33 | $5,956.00 | $5,956.00 | 2024-10-01 | MRF ↗ |
| CACHE VALLEY HOSPITAL Outpatient | Public Employees | SummitExclusive | $1,854.73 | $6,999.00 | $6,999.00 | 2026-03-01 | MRF ↗ |
| ST MARK'S HOSPITAL Outpatient | University of Utah | HIXIndividual | $1,894.01 | $5,956.00 | $5,956.00 | 2024-10-01 | MRF ↗ |
| BRIGHAM CITY COMMUNITY HOSPITAL Outpatient | Cigna | IFPLP | $1,912.71 | $7,807.00 | $7,807.00 | 2026-03-01 | MRF ↗ |
| CACHE VALLEY HOSPITAL Outpatient | Cigna | OAPNBN | $1,938.72 | $6,999.00 | $6,999.00 | 2026-03-01 | MRF ↗ |
| BRIGHAM CITY COMMUNITY HOSPITAL Outpatient | Sterling Life Insurance | MCR | $1,951.75 | $7,807.00 | $7,807.00 | 2026-03-01 | MRF ↗ |
| CACHE VALLEY HOSPITAL Outpatient | Bright Health | HIX | $1,959.72 | $6,999.00 | $6,999.00 | 2026-03-01 | MRF ↗ |
| ST MARK'S HOSPITAL Outpatient | Aetna | PeakPreference | $1,965.48 | $5,956.00 | $5,956.00 | 2024-10-01 | MRF ↗ |
| ST MARK'S HOSPITAL Outpatient | Cigna | Exclusive | $1,971.44 | $5,956.00 | $5,956.00 | 2024-10-01 | MRF ↗ |
| ST MARK'S HOSPITAL Outpatient | Molina | HIX | $1,989.30 | $5,956.00 | $5,956.00 | 2024-10-01 | MRF ↗ |
| BRIGHAM CITY COMMUNITY HOSPITAL Outpatient | Public Employees | SummitExclusive | $2,068.86 | $7,807.00 | $7,807.00 | 2026-03-01 | MRF ↗ |
| ST MARK'S HOSPITAL Outpatient | PEHP | Summit | $2,114.38 | $5,956.00 | $5,956.00 | 2024-10-01 | MRF ↗ |
| CACHE VALLEY HOSPITAL Outpatient | Molina | HIX | $2,127.70 | $6,999.00 | $6,999.00 | 2026-03-01 | MRF ↗ |
| BRIGHAM CITY COMMUNITY HOSPITAL Outpatient | Cigna | OAPNBN | $2,162.54 | $7,807.00 | $7,807.00 | 2026-03-01 | MRF ↗ |
| ST MARK'S HOSPITAL Outpatient | University of Utah | HealthyPremierSSG | $2,179.90 | $5,956.00 | $5,956.00 | 2024-10-01 | MRF ↗ |
| ST MARK'S HOSPITAL Outpatient | University of Utah | HealthyPreferred | $2,179.90 | $5,956.00 | $5,956.00 | 2024-10-01 | MRF ↗ |
| BRIGHAM CITY COMMUNITY HOSPITAL Outpatient | Aetna | PeakPreference | $2,185.96 | $7,807.00 | $7,807.00 | 2026-03-01 | MRF ↗ |
| BRIGHAM CITY COMMUNITY HOSPITAL Outpatient | Bright Health | HIX | $2,185.96 | $7,807.00 | $7,807.00 | 2026-03-01 | MRF ↗ |
| CACHE VALLEY HOSPITAL Outpatient | Cigna | Exclusive | $2,225.68 | $6,999.00 | $6,999.00 | 2026-03-01 | MRF ↗ |
| CACHE VALLEY HOSPITAL Outpatient | University of Utah | HIXIndividual | $2,225.68 | $6,999.00 | $6,999.00 | 2026-03-01 | MRF ↗ |
| ST MARK'S HOSPITAL Outpatient | DMBA (Deseret Mutual Benefit Admin) | PPO | $2,246.01 | $5,956.00 | $5,956.00 | 2024-10-01 | MRF ↗ |
| BRIGHAM CITY COMMUNITY HOSPITAL Outpatient | Molina | HIX | $2,373.33 | $7,807.00 | $7,807.00 | 2026-03-01 | MRF ↗ |
| ST MARK'S HOSPITAL Outpatient | University of Utah | HealthyPremier | $2,376.44 | $5,956.00 | $5,956.00 | 2024-10-01 | MRF ↗ |
| CACHE VALLEY HOSPITAL Outpatient | Public Employees | Summit | $2,379.66 | $6,999.00 | $6,999.00 | 2026-03-01 | MRF ↗ |
| ST MARK'S HOSPITAL Outpatient | Cigna UT Overstock | COMM | $2,382.40 | $5,956.00 | $5,956.00 | 2024-10-01 | MRF ↗ |
| ST MARK'S HOSPITAL Outpatient | Universal Healthcare | MCR | $2,382.40 | $5,956.00 | $5,956.00 | 2024-10-01 | MRF ↗ |
| CACHE VALLEY HOSPITAL Outpatient | Regence | FocalPointPlus | $2,479.05 | $6,999.00 | $6,999.00 | 2026-03-01 | MRF ↗ |
| BRIGHAM CITY COMMUNITY HOSPITAL Outpatient | Cigna | Exclusive | $2,482.63 | $7,807.00 | $7,807.00 | 2026-03-01 | MRF ↗ |
| BRIGHAM CITY COMMUNITY HOSPITAL Outpatient | University of Utah | HIXIndividual | $2,482.63 | $7,807.00 | $7,807.00 | 2026-03-01 | MRF ↗ |
| ST MARK'S HOSPITAL Outpatient | Aetna | StandardNetwork | $2,561.08 | $5,956.00 | $5,956.00 | 2024-10-01 | MRF ↗ |
| CACHE VALLEY HOSPITAL Outpatient | University of Utah | HealthyPremierSSG | $2,561.63 | $6,999.00 | $6,999.00 | 2026-03-01 | MRF ↗ |
| CACHE VALLEY HOSPITAL Outpatient | University of Utah | HealthyPreferred | $2,561.63 | $6,999.00 | $6,999.00 | 2026-03-01 | MRF ↗ |
| CACHE VALLEY HOSPITAL Outpatient | DMBA (Deseret Mutual Benefit Admin) | PPO | $2,565.83 | $6,999.00 | $6,999.00 | 2026-03-01 | MRF ↗ |
| CACHE VALLEY HOSPITAL Outpatient | Aetna | PeakPreference | $2,589.63 | $6,999.00 | $6,999.00 | 2026-03-01 | MRF ↗ |
| ST MARK'S HOSPITAL Outpatient | Cigna | NBNPPO | $2,620.64 | $5,956.00 | $5,956.00 | 2024-10-01 | MRF ↗ |
| BRIGHAM CITY COMMUNITY HOSPITAL Outpatient | Public Employees | Summit | $2,654.38 | $7,807.00 | $7,807.00 | 2026-03-01 | MRF ↗ |
| ST MARK'S HOSPITAL Outpatient | Humana ChoiceCare | PPO | $2,664.12 | $5,956.00 | $5,956.00 | 2024-10-01 | MRF ↗ |
| CACHE VALLEY HOSPITAL Outpatient | Regence | Participating | $2,754.11 | $6,999.00 | $6,999.00 | 2026-03-01 | MRF ↗ |
| CACHE VALLEY HOSPITAL Outpatient | Regence | Preferred | $2,754.11 | $6,999.00 | $6,999.00 | 2026-03-01 | MRF ↗ |
| CACHE VALLEY HOSPITAL Outpatient | Regence | PPO | $2,754.11 | $6,999.00 | $6,999.00 | 2026-03-01 | MRF ↗ |
| CACHE VALLEY HOSPITAL Outpatient | Regence | Traditional | $2,754.11 | $6,999.00 | $6,999.00 | 2026-03-01 | MRF ↗ |
| CACHE VALLEY HOSPITAL Outpatient | Regence | RealValue | $2,754.11 | $6,999.00 | $6,999.00 | 2026-03-01 | MRF ↗ |
| CACHE VALLEY HOSPITAL Outpatient | Regence | FocalPoint | $2,754.11 | $6,999.00 | $6,999.00 | 2026-03-01 | MRF ↗ |
| CACHE VALLEY HOSPITAL Outpatient | Regence | Individual | $2,754.11 | $6,999.00 | $6,999.00 | 2026-03-01 | MRF ↗ |
| BRIGHAM CITY COMMUNITY HOSPITAL Outpatient | Regence | FocalPointPlus | $2,765.24 | $7,807.00 | $7,807.00 | 2026-03-01 | MRF ↗ |
| ST MARK'S HOSPITAL Outpatient | Imagine Health Wise | PPO | $2,767.75 | $5,956.00 | $5,956.00 | 2024-10-01 | MRF ↗ |
| CACHE VALLEY HOSPITAL Outpatient | University of Utah | HealthyPremier | $2,792.60 | $6,999.00 | $6,999.00 | 2026-03-01 | MRF ↗ |
| CACHE VALLEY HOSPITAL Outpatient | Cigna UT Overstock | COMM | $2,799.60 | $6,999.00 | $6,999.00 | 2026-03-01 | MRF ↗ |
| BRIGHAM CITY COMMUNITY HOSPITAL Outpatient | University of Utah | HealthyPremierSSG | $2,857.36 | $7,807.00 | $7,807.00 | 2026-03-01 | MRF ↗ |
| BRIGHAM CITY COMMUNITY HOSPITAL Outpatient | University of Utah | HealthyPreferred | $2,857.36 | $7,807.00 | $7,807.00 | 2026-03-01 | MRF ↗ |
| ST MARK'S HOSPITAL Outpatient | MotivHealth | COMM | $2,858.88 | $5,956.00 | $5,956.00 | 2024-10-01 | MRF ↗ |
| ST MARK'S HOSPITAL Outpatient | MotivHealth | TPARental | $2,858.88 | $5,956.00 | $5,956.00 | 2024-10-01 | MRF ↗ |
| ST MARK'S HOSPITAL Outpatient | Angle Insurance | COMM | $2,858.88 | $5,956.00 | $5,956.00 | 2024-10-01 | MRF ↗ |
| BRIGHAM CITY COMMUNITY HOSPITAL Outpatient | Aetna | StandardNetwork | $2,888.59 | $7,807.00 | $7,807.00 | 2026-03-01 | MRF ↗ |
| CACHE VALLEY HOSPITAL Outpatient | Cigna | NBNPPO | $2,953.58 | $6,999.00 | $6,999.00 | 2026-03-01 | MRF ↗ |
| BRIGHAM CITY COMMUNITY HOSPITAL Outpatient | Regence | Traditional | $3,072.05 | $7,807.00 | $7,807.00 | 2026-03-01 | MRF ↗ |
| BRIGHAM CITY COMMUNITY HOSPITAL Outpatient | Regence | Individual | $3,072.05 | $7,807.00 | $7,807.00 | 2026-03-01 | MRF ↗ |
| BRIGHAM CITY COMMUNITY HOSPITAL Outpatient | Regence | Preferred | $3,072.05 | $7,807.00 | $7,807.00 | 2026-03-01 | MRF ↗ |
| BRIGHAM CITY COMMUNITY HOSPITAL Outpatient | Regence | PPO | $3,072.05 | $7,807.00 | $7,807.00 | 2026-03-01 | MRF ↗ |
| BRIGHAM CITY COMMUNITY HOSPITAL Outpatient | Regence | RealValue | $3,072.05 | $7,807.00 | $7,807.00 | 2026-03-01 | MRF ↗ |
| BRIGHAM CITY COMMUNITY HOSPITAL Outpatient | Regence | FocalPoint | $3,072.05 | $7,807.00 | $7,807.00 | 2026-03-01 | MRF ↗ |
| BRIGHAM CITY COMMUNITY HOSPITAL Outpatient | Regence | Participating | $3,072.05 | $7,807.00 | $7,807.00 | 2026-03-01 | MRF ↗ |
| CACHE VALLEY HOSPITAL Outpatient | Imagine Health Wise | PPO | $3,101.96 | $6,999.00 | $6,999.00 | 2026-03-01 | MRF ↗ |
| BRIGHAM CITY COMMUNITY HOSPITAL Outpatient | University of Utah | HealthyPremier | $3,114.99 | $7,807.00 | $7,807.00 | 2026-03-01 | MRF ↗ |
| BRIGHAM CITY COMMUNITY HOSPITAL Outpatient | Universal Healthcare | MCR | $3,122.80 | $7,807.00 | $7,807.00 | 2026-03-01 | MRF ↗ |
| BRIGHAM CITY COMMUNITY HOSPITAL Outpatient | Cigna UT Overstock | COMM | $3,122.80 | $7,807.00 | $7,807.00 | 2026-03-01 | MRF ↗ |
| ST MARK'S HOSPITAL Outpatient | Aetna | AetnaSignatureAdministrators | $3,156.68 | $5,956.00 | $5,956.00 | 2024-10-01 | MRF ↗ |
| CACHE VALLEY HOSPITAL Outpatient | MotivHealth | MotivNet | $3,219.54 | $6,999.00 | $6,999.00 | 2026-03-01 | MRF ↗ |
| CACHE VALLEY HOSPITAL Outpatient | MotivHealth | Wasatch | $3,219.54 | $6,999.00 | $6,999.00 | 2026-03-01 | MRF ↗ |
| CACHE VALLEY HOSPITAL Outpatient | MotivHealth | TPARental | $3,219.54 | $6,999.00 | $6,999.00 | 2026-03-01 | MRF ↗ |
| CACHE VALLEY HOSPITAL Outpatient | MotivHealth | WasatchPlus | $3,219.54 | $6,999.00 | $6,999.00 | 2026-03-01 | MRF ↗ |
| CACHE VALLEY HOSPITAL Outpatient | MotivHealth | MotivSelect | $3,219.54 | $6,999.00 | $6,999.00 | 2026-03-01 | MRF ↗ |
| ST MARK'S HOSPITAL Outpatient | Aetna | UtahConnectedNetwork | $3,275.80 | $5,956.00 | $5,956.00 | 2024-10-01 | MRF ↗ |
| BRIGHAM CITY COMMUNITY HOSPITAL Outpatient | Cigna | NBNPPO | $3,294.55 | $7,807.00 | $7,807.00 | 2026-03-01 | MRF ↗ |
| ST MARK'S HOSPITAL Outpatient | Cigna | Non-ExclusivePPO | $3,311.54 | $5,956.00 | $5,956.00 | 2024-10-01 | MRF ↗ |
| CACHE VALLEY HOSPITAL Outpatient | Aetna | StandardNetwork | $3,429.51 | $6,999.00 | $6,999.00 | 2026-03-01 | MRF ↗ |
| ST MARK'S HOSPITAL Outpatient | Select Health ER | COMM | $3,442.57 | $5,956.00 | $5,956.00 | 2024-10-01 | MRF ↗ |
| BRIGHAM CITY COMMUNITY HOSPITAL Outpatient | Imagine Health Wise | PPO | $3,460.06 | $7,807.00 | $7,807.00 | 2026-03-01 | MRF ↗ |
| BRIGHAM CITY COMMUNITY HOSPITAL Outpatient | MotivHealth | WasatchPlus | $3,591.22 | $7,807.00 | $7,807.00 | 2026-03-01 | MRF ↗ |
| BRIGHAM CITY COMMUNITY HOSPITAL Outpatient | MotivHealth | TPARental | $3,591.22 | $7,807.00 | $7,807.00 | 2026-03-01 | MRF ↗ |
| BRIGHAM CITY COMMUNITY HOSPITAL Outpatient | MotivHealth | Wasatch | $3,591.22 | $7,807.00 | $7,807.00 | 2026-03-01 | MRF ↗ |
| BRIGHAM CITY COMMUNITY HOSPITAL Outpatient | MotivHealth | MotivNet | $3,591.22 | $7,807.00 | $7,807.00 | 2026-03-01 | MRF ↗ |
| BRIGHAM CITY COMMUNITY HOSPITAL Outpatient | MotivHealth | MotivSelect | $3,591.22 | $7,807.00 | $7,807.00 | 2026-03-01 | MRF ↗ |
| BRIGHAM CITY COMMUNITY HOSPITAL Outpatient | Aetna | AetnaSignatureAdministrators | $3,669.29 | $7,807.00 | $7,807.00 | 2026-03-01 | MRF ↗ |
| CACHE VALLEY HOSPITAL Outpatient | Cigna | Non-ExclusivePPO | $3,730.47 | $6,999.00 | $6,999.00 | 2026-03-01 | MRF ↗ |
| BRIGHAM CITY COMMUNITY HOSPITAL Outpatient | Aetna | UtahConnectedNetwork | $3,747.36 | $7,807.00 | $7,807.00 | 2026-03-01 | MRF ↗ |
| ST MARK'S HOSPITAL Outpatient | Multiplan | Primary | $3,752.28 | $5,956.00 | $5,956.00 | 2024-10-01 | MRF ↗ |
| CACHE VALLEY HOSPITAL Outpatient | Public Employees | PrefferedNetwork | $3,870.45 | $6,999.00 | $6,999.00 | 2026-03-01 | MRF ↗ |
| ST MARK'S HOSPITAL Outpatient | Union Pacific Railroad | COMM | $3,871.40 | $5,956.00 | $5,956.00 | 2024-10-01 | MRF ↗ |
| CACHE VALLEY HOSPITAL Outpatient | Select Health ER | COMM | $4,045.42 | $6,999.00 | $6,999.00 | 2026-03-01 | MRF ↗ |
| ST MARK'S HOSPITAL Outpatient | Aetna | FirstHealth | $4,050.08 | $5,956.00 | $5,956.00 | 2024-10-01 | MRF ↗ |
| BRIGHAM CITY COMMUNITY HOSPITAL Outpatient | Cigna | Non-ExclusivePPO | $4,161.13 | $7,807.00 | $7,807.00 | 2026-03-01 | MRF ↗ |
| ST MARK'S HOSPITAL Outpatient | EverNorth BH | COMM | $4,169.20 | $5,956.00 | $5,956.00 | 2024-10-01 | MRF ↗ |
| BRIGHAM CITY COMMUNITY HOSPITAL Outpatient | Public Employees | PrefferedNetwork | $4,317.27 | $7,807.00 | $7,807.00 | 2026-03-01 | MRF ↗ |
| CACHE VALLEY HOSPITAL Outpatient | Aetna | AetnaSignatureAdministrators | $4,339.38 | $6,999.00 | $6,999.00 | 2026-03-01 | MRF ↗ |
| CACHE VALLEY HOSPITAL Outpatient | Aetna | UtahConnectedNetwork | $4,479.36 | $6,999.00 | $6,999.00 | 2026-03-01 | MRF ↗ |
| BRIGHAM CITY COMMUNITY HOSPITAL Outpatient | Select Health ER | COMM | $4,512.45 | $7,807.00 | $7,807.00 | 2026-03-01 | MRF ↗ |
| CACHE VALLEY HOSPITAL Outpatient | Aetna | FirstHealth | $4,549.35 | $6,999.00 | $6,999.00 | 2026-03-01 | MRF ↗ |
| ST MARK'S HOSPITAL Outpatient | Injury Care of Utah | WCOMP | $4,645.68 | $5,956.00 | $5,956.00 | 2024-10-01 | MRF ↗ |
| BRIGHAM CITY COMMUNITY HOSPITAL Outpatient | DMBA (Deseret Mutual Benefit Admin) | PPO | $4,663.90 | $7,807.00 | $7,807.00 | 2026-03-01 | MRF ↗ |
| CACHE VALLEY HOSPITAL Outpatient | Multiplan | Primary | $4,689.33 | $6,999.00 | $6,999.00 | 2026-03-01 | MRF ↗ |
| ST MARK'S HOSPITAL Outpatient | TriWest Healthcare Alliance | Veterans | $4,764.80 | $5,956.00 | $5,956.00 | 2024-10-01 | MRF ↗ |
| ST MARK'S HOSPITAL Outpatient | USA Managed Care | PPO | $5,062.60 | $5,956.00 | $5,956.00 | 2024-10-01 | MRF ↗ |
| BRIGHAM CITY COMMUNITY HOSPITAL Outpatient | Union Pacific Railroad | COMM | $5,074.55 | $7,807.00 | $7,807.00 | 2026-03-01 | MRF ↗ |
| CACHE VALLEY HOSPITAL Outpatient | Select Health CHIP | MCD | $5,249.25 | $6,999.00 | $6,999.00 | 2026-03-01 | MRF ↗ |
| BRIGHAM CITY COMMUNITY HOSPITAL Outpatient | Aetna | FirstHealth | $5,699.11 | $7,807.00 | $7,807.00 | 2026-03-01 | MRF ↗ |
| CACHE VALLEY HOSPITAL Outpatient | FedMed | COMM | $5,949.15 | $6,999.00 | $6,999.00 | 2026-03-01 | MRF ↗ |
| BRIGHAM CITY COMMUNITY HOSPITAL Outpatient | Injury Care of Utah | WCOMP | $6,089.46 | $7,807.00 | $7,807.00 | 2026-03-01 | MRF ↗ |
| BRIGHAM CITY COMMUNITY HOSPITAL Outpatient | Autoliv ASP | COMM | $6,245.60 | $7,807.00 | $7,807.00 | 2026-03-01 | MRF ↗ |
| BRIGHAM CITY COMMUNITY HOSPITAL Outpatient | TriWest Healthcare Alliance | Veterans | $6,245.60 | $7,807.00 | $7,807.00 | 2026-03-01 | MRF ↗ |
| BRIGHAM CITY COMMUNITY HOSPITAL Outpatient | Multiplan | Primary | $6,401.74 | $7,807.00 | $7,807.00 | 2026-03-01 | MRF ↗ |
| BRIGHAM CITY COMMUNITY HOSPITAL Outpatient | USA Managed Care | PPO | $7,026.30 | $7,807.00 | $7,807.00 | 2026-03-01 | MRF ↗ |
| St. David's Georgetown Hospital Outpatient | Amerigroup | MCD | $23,514.40 | $167,960.00 | $167,960.00 | 2026-03-01 | MRF ↗ |
| St. David's Georgetown Hospital Outpatient | Amerigroup | CHIP | $23,514.40 | $167,960.00 | $167,960.00 | 2026-03-01 | MRF ↗ |
| St. David's Georgetown Hospital Outpatient | BCBS | MyBlueHealth | $25,026.04 | $167,960.00 | $167,960.00 | 2026-03-01 | MRF ↗ |
| St. David's Georgetown Hospital Outpatient | Superior Health Plan | ValueHMO | $28,553.20 | $167,960.00 | $167,960.00 | 2026-03-01 | MRF ↗ |
| St. David's Georgetown Hospital Outpatient | Superior Health Plan | AmbetterEPO | $28,553.20 | $167,960.00 | $167,960.00 | 2026-03-01 | MRF ↗ |
| St. David's Georgetown Hospital Outpatient | Superior Health Plan | AmbetterHMO | $28,553.20 | $167,960.00 | $167,960.00 | 2026-03-01 | MRF ↗ |
| St. David's Georgetown Hospital Outpatient | BCBS | BlueAdvantage | $29,393.00 | $167,960.00 | $167,960.00 | 2026-03-01 | MRF ↗ |
| St. David's Georgetown Hospital Outpatient | United | OptionsPPO | $41,822.04 | $167,960.00 | $167,960.00 | 2026-03-01 | MRF ↗ |
| St. David's Georgetown Hospital Outpatient | BCBS | BlueEssentialsAccess | $45,853.08 | $167,960.00 | $167,960.00 | 2026-03-01 | MRF ↗ |
| St. David's Georgetown Hospital Outpatient | BCBS | BlueEssentials | $45,853.08 | $167,960.00 | $167,960.00 | 2026-03-01 | MRF ↗ |
| St. David's Georgetown Hospital Outpatient | BCBS | EPOSOA | $49,716.16 | $167,960.00 | $167,960.00 | 2026-03-01 | MRF ↗ |
| St. David's Georgetown Hospital Outpatient | IMO Med - Select Network | WC | $50,388.00 | $167,960.00 | $167,960.00 | 2026-03-01 | MRF ↗ |
| St. David's Georgetown Hospital Outpatient | BCBS | Traditional | $53,579.24 | $167,960.00 | $167,960.00 | 2026-03-01 | MRF ↗ |
| St. David's Georgetown Hospital Outpatient | BCBS | PPO | $53,579.24 | $167,960.00 | $167,960.00 | 2026-03-01 | MRF ↗ |
| St. David's Georgetown Hospital Outpatient | Sendero | ACHP | $53,747.20 | $167,960.00 | $167,960.00 | 2026-03-01 | MRF ↗ |
| St. David's Georgetown Hospital Outpatient | Shared Health | MGMCR | $58,786.00 | $167,960.00 | $167,960.00 | 2026-03-01 | MRF ↗ |
| St. David's Georgetown Hospital Outpatient | Texas Healthcare Foundation HEB | WC | $62,145.20 | $167,960.00 | $167,960.00 | 2026-03-01 | MRF ↗ |
| St. David's Georgetown Hospital Outpatient | Texas Healthcare Foundation HEB | COMM | $62,145.20 | $167,960.00 | $167,960.00 | 2026-03-01 | MRF ↗ |
| St. David's Georgetown Hospital Outpatient | Texas Workforce Commission | WCOMP | $65,504.40 | $167,960.00 | $167,960.00 | 2026-03-01 | MRF ↗ |
| St. David's Georgetown Hospital Outpatient | Averde Health | COMM | $75,582.00 | $167,960.00 | $167,960.00 | 2026-03-01 | MRF ↗ |
| St. David's Georgetown Hospital Outpatient | United | GlobalBenefitPlan | $75,582.00 | $167,960.00 | $167,960.00 | 2026-03-01 | MRF ↗ |
| St. David's Georgetown Hospital Outpatient | NaphCare | MGMCR | $75,582.00 | $167,960.00 | $167,960.00 | 2026-03-01 | MRF ↗ |
| St. David's Georgetown Hospital Outpatient | Comanche County | LOCALGOV | $83,980.00 | $167,960.00 | $167,960.00 | 2026-03-01 | MRF ↗ |
| St. David's Georgetown Hospital Outpatient | Austin FC | WORKERSCOMP | $83,980.00 | $167,960.00 | $167,960.00 | 2026-03-01 | MRF ↗ |
| St. David's Georgetown Hospital Outpatient | Physicians Cooperative of Texas | WC | $92,378.00 | $167,960.00 | $167,960.00 | 2026-03-01 | MRF ↗ |
| St. David's Georgetown Hospital Outpatient | HealthSmart Preferred Care | Accel | $92,378.00 | $167,960.00 | $167,960.00 | 2026-03-01 | MRF ↗ |
| St. David's Georgetown Hospital Outpatient | Independent Medical Systems | COMM | $92,378.00 | $167,960.00 | $167,960.00 | 2026-03-01 | MRF ↗ |
| St. David's Georgetown Hospital Outpatient | Prime Health | WC | $100,776.00 | $167,960.00 | $167,960.00 | 2026-03-01 | MRF ↗ |
| St. David's Georgetown Hospital Outpatient | National Health Care | COMM | $109,174.00 | $167,960.00 | $167,960.00 | 2026-03-01 | MRF ↗ |
| St. David's Georgetown Hospital Outpatient | Coastal Comp Health Networks | WORKERSCOMP | $109,174.00 | $167,960.00 | $167,960.00 | 2026-03-01 | MRF ↗ |
| St. David's Georgetown Hospital Outpatient | MedCorp Southwest | COMM | $125,970.00 | $167,960.00 | $167,960.00 | 2026-03-01 | MRF ↗ |
| St. David's Georgetown Hospital Outpatient | HealthSmart Preferred Care | COMM | $134,368.00 | $167,960.00 | $167,960.00 | 2026-03-01 | MRF ↗ |
| St. David's Georgetown Hospital Outpatient | Medical Control Network Solutions | MedicalControlNetwork | $151,164.00 | $167,960.00 | $167,960.00 | 2026-03-01 | MRF ↗ |
| St. David's Georgetown Hospital Outpatient | Beech Street | COMMPPO | $151,164.00 | $167,960.00 | $167,960.00 | 2026-03-01 | MRF ↗ |
| St. David's Georgetown Hospital Outpatient | Multiplan | COMMPPO | $151,164.00 | $167,960.00 | $167,960.00 | 2026-03-01 | MRF ↗ |