35190 — Repair Acq Av Fistula Xtr
Cite this view
HANK Price Transparency. (n.d.). Repair acq av fistula xtr (OTHER 35190) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/35190?code_type=OTHER
“Repair acq av fistula xtr (OTHER 35190) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/35190?code_type=OTHER. Accessed .
“Repair acq av fistula xtr (OTHER 35190) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/35190?code_type=OTHER.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $721–$6,440 (25th–75th percentile) across 191 hospitals · 443 payers.
“Negotiated” is the hospital’s negotiated facility rate for this OTHER 35190 — 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 | Aetna | Medicare Advantage Hmo | $12.75 | — | — | 2026-05-27 | MRF ↗ |
| VIRGINIA MASON MEDICAL CENTER Outpatient | First Choice | Commercial | $22.28 | — | — | 2026-05-27 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Arkansas Total Care | Medicaid | $43.14 | — | — | 2026-05-09 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Caresource | Medicaid | $44.86 | — | — | 2026-05-09 | MRF ↗ |
| VIRGINIA MASON MEDICAL CENTER Outpatient | Confluence Health | Medicare Advantage | $56.79 | — | — | 2026-05-27 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Health Alliance | Commercial | $71.53 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Health Alliance | Commercial | $71.53 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Aetna | Medicare | $90.48 | $377.00 | $226.20 | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Aetna | Medicare | $90.48 | $377.00 | $226.20 | 2026-05-24 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Humana Choicecare | Medicare | $102.94 | — | — | 2026-05-09 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Viva | Medicare Advantage | $104.18 | — | — | 2026-05-06 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Humana | Medicare Advantage | $104.18 | — | — | 2026-05-06 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Blue Cross | Medicare Advantage | $104.18 | — | — | 2026-05-06 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Viva | Commercial | $104.18 | — | — | 2026-05-06 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Cigna | Commercial | $104.18 | — | — | 2026-05-06 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Aetna | Commercial | $104.18 | — | — | 2026-05-06 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Simpra | Medicare Advantage | $104.18 | — | — | 2026-05-06 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Ambetter | Commercial | $105.00 | — | — | 2026-05-09 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Bcbs | Medicare | $105.00 | — | — | 2026-05-09 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Complete Blue Mcr Adv | $105.12 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Community Blue Mcr Adv | $105.12 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Complete Blue Mcr Adv | $105.12 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Community Blue Mcr Adv | $105.12 | — | — | 2026-05-23 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Simpra | Medicare Advantage | $105.56 | — | — | 2026-05-13 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Simpra | Medicare Advantage | $105.56 | — | — | 2026-05-23 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Humana | Medicare Advantage | $105.56 | — | — | 2026-05-13 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Viva | Medicare Advantage | $105.56 | — | — | 2026-05-23 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Humana | Medicare Advantage | $105.56 | — | — | 2026-05-23 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Viva | Medicare Advantage | $105.56 | — | — | 2026-05-13 | MRF ↗ |
| PENN HIGHLANDS CONNELLSVILLE Outpatient | Blue Cross | Freedom Blue Mcr Adv | $106.24 | — | — | 2026-05-09 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Freedom Blue Mcr Adv | $106.24 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Freedom Blue Mcr Adv | $106.24 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS CONNELLSVILLE Outpatient | Blue Cross | Freedom Blue Mcr Adv | $106.24 | — | — | 2026-05-09 | MRF ↗ |
| PENN HIGHLANDS CONNELLSVILLE Outpatient | Blue Cross | Complete Blue Mcr Adv | $107.92 | — | — | 2026-05-09 | MRF ↗ |
| PENN HIGHLANDS CONNELLSVILLE Outpatient | Blue Cross | Community Blue Mcr Adv | $107.92 | — | — | 2026-05-09 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Windsor | Medicare | $108.09 | — | — | 2026-05-09 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Wellcare | Medicare | $108.09 | — | — | 2026-05-09 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Cigna Healthspring | Medicare | $108.09 | — | — | 2026-05-09 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Hfn | Commercial | $111.36 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | United Healthcare | Commercial | $111.36 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | United Healthcare | Commercial | $111.36 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Hfn | Commercial | $111.36 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - All Social Mission | $111.83 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - My Blue Access Ppo | $111.83 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Managed Care | $111.83 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Traditional Medicare | Traditional Medicare | $111.83 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS CONNELLSVILLE Outpatient | Geisinger | Mcr Advantage | $111.83 | — | — | 2026-05-09 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Traditional Medicare | Traditional Medicare | $111.83 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Performance Blue | $111.83 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Performance Blue | $111.83 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - My Blue Access Ppo | $111.83 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS CONNELLSVILLE Outpatient | Traditional Medicare | Traditional Medicare | $111.83 | — | — | 2026-05-09 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - All Social Mission | $111.83 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Indemnity | $111.83 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Managed Care | $111.83 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Aca | $111.83 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Aca | $111.83 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Indemnity | $111.83 | — | — | 2026-05-23 | MRF ↗ |
| FISHER-TITUS HOSPITAL Outpatient | Optum | Vaccnoptum | $113.22 | — | — | 2026-05-27 | MRF ↗ |
| FISHER-TITUS HOSPITAL Outpatient | Optum | Vaccnoptum | $113.22 | — | — | 2026-05-27 | MRF ↗ |
| FISHER-TITUS HOSPITAL Outpatient | Perennial Advantage | Perennial Advantage | $113.22 | — | — | 2026-05-27 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Upmc | Mcr Advantage | $114.07 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Upmc | Hmo Epo | $114.07 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Upmc | Hmo Epo | $114.07 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Upmc | Mcr Advantage | $114.07 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Humana | Mcr Advantage | $115.19 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Uhc | Mcr Advantage | $115.19 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Uhc | Mcr Advantage | $115.19 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Humana | Mcr Advantage | $115.19 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS CONNELLSVILLE Outpatient | Uhc | Mcr Advantage | $115.19 | — | — | 2026-05-09 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Geisinger | Mcr Advantage | $115.19 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Uhc | Mcr Advantage | $115.19 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Geisinger | Mcr Advantage | $115.19 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Uhc | Mcr Advantage | $115.19 | — | — | 2026-05-23 | MRF ↗ |
| GRADY MEMORIAL HOSPITAL Outpatient | Amerigroup | Medicaid | $116.21 | — | — | 2026-05-07 | MRF ↗ |
| GRADY MEMORIAL HOSPITAL Outpatient | Peach State | Medicaid | $116.21 | — | — | 2026-05-07 | MRF ↗ |
| JASPER MEMORIAL HOSPITAL Outpatient | Caresource | Commercial | $116.21 | — | — | 2026-05-06 | MRF ↗ |
| JASPER MEMORIAL HOSPITAL Outpatient | Peach State | Medicaid | $116.21 | — | — | 2026-05-06 | MRF ↗ |
| JASPER MEMORIAL HOSPITAL Outpatient | Amerigroup | Medicaid | $116.21 | — | — | 2026-05-06 | MRF ↗ |
| GRADY MEMORIAL HOSPITAL Outpatient | Caresource | Commercial | $116.21 | — | — | 2026-05-07 | MRF ↗ |
| FISHER-TITUS HOSPITAL Outpatient | Sidecar | Sidecarcommercial | $116.68 | — | — | 2026-05-27 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Uhc | Medicare Advantage | $116.82 | — | — | 2026-05-14 | MRF ↗ |
| CABELL HUNTINGTON HOSPITAL, INC Outpatient | Highmark Blue Cross | Ppo/Pos | $116.82 | — | — | 2026-05-14 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Aetna | Medicare Adv Ppo | $116.82 | — | — | 2026-05-14 | MRF ↗ |
| CABELL HUNTINGTON HOSPITAL, INC Outpatient | Peak Health | Medicare | $116.82 | — | — | 2026-05-14 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | American Health | Medicare Adv Ut Hmo I-Snp | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SPANISH FORK HOSPITAL Outpatient | Molina | Medicare Advantage | $116.82 | — | — | 2026-05-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH SPANISH FORK HOSPITAL Outpatient | Humana | Medicare Choice Ppo | $116.82 | — | — | 2026-05-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Uhc | Medicare Advantage | $116.82 | — | — | 2026-05-14 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Uhc | Medicare Advantage | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| CABELL HUNTINGTON HOSPITAL, INC Outpatient | Peia | Other Governmental | $116.82 | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Humana | Medicare Choice Ppo | $116.82 | — | — | 2026-05-14 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Regence Bcbs | Medadvantage Ppo | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Selecthealth | Medicaid | $116.82 | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH SPANISH FORK HOSPITAL Outpatient | Molina | Medicare Complete Care Hmo Snp | $116.82 | — | — | 2026-05-15 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Health Plan Of Nevada | Medicaid | $116.82 | — | — | 2026-05-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Selecthealth | Medicaid | $116.82 | — | — | 2026-05-14 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Selecthealth | Medicaid | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Selecthealth | Medicare Advantage | $116.82 | — | — | 2026-05-14 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Selecthealth | Medicare Advantage | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | American Health | Medicare Adv Ut Hmo I-Snp | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Aetna | Medicare Adv Ppo | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | American Health | Medicare Adv Ut Hmo I-Snp | $116.82 | — | — | 2026-05-14 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Molina | Medicare Complete Care Hmo Snp | $116.82 | — | — | 2026-05-14 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Aetna | Medicare Adv Hmo | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Selecthealth | Medicare Advantage | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Uhc | Medicare Advantage | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Molina | Medicaid | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Health Plan Of Nevada | Medicaid | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Health Partners Of Nevada | Medicare Advantage | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Selecthealth | Medicare Advantage | $116.82 | — | — | 2026-05-14 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Health Partners Of Nevada | Medicare Advantage | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Regence Bcbs | Medadvantage | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Humana | Medicare Choice Ppo | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Uhc | Medicare Advantage | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Aetna | Medicare Adv Ppo | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Aetna | Medicare Adv Hmo | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Aetna | Medicare Adv Hmo | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Molina | Medicare Complete Care Hmo Snp | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Health Choice | Medicaid | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | American Health | Medicare Adv Ut Hmo I-Snp | $116.82 | — | — | 2026-05-13 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Uhc | Medicare Advantage | $116.82 | — | — | 2026-05-13 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Selecthealth | Med Individual Aca | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Molina | Medicare Choice Care Hmo | $116.82 | — | — | 2026-05-13 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Selecthealth | Medicaid | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Health Plan Of Nevada | Medicaid | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Aetna | Medicare Adv Hmo | $116.82 | — | — | 2026-05-14 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Health Plan Of Nevada | Medicaid | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Molina | Medicare Complete Care Hmo Snp | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Molina | Medicare Choice Care Hmo | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Molina | Medicaid | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Aetna | Medicare Adv Hmo | $116.82 | — | — | 2026-05-14 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Molina | Medicare Choice Care Hmo | $116.82 | — | — | 2026-05-14 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Molina | Medicaid | $116.82 | — | — | 2026-05-14 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Healthy U | Medicaid | $116.82 | — | — | 2026-05-15 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Healthy U | Medicaid | $116.82 | — | — | 2026-05-13 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Health Partners Of Nevada | Medicare Advantage | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| CABELL HUNTINGTON HOSPITAL, INC Outpatient | United Healthcare | Medicare | $116.82 | — | — | 2026-05-14 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Health Plan Of Nevada | Medicaid | $116.82 | — | — | 2026-05-13 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Healthy U | Medicaid | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Healthy U | Medicaid | $116.82 | — | — | 2026-05-14 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Selecthealth | Medicaid | $116.82 | — | — | 2026-05-13 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Southwest Behavioral Health | Behavioral Health | $116.82 | — | — | 2026-05-13 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Regence Bcbs | Medadvantage Ppo | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Selecthealth | Medicaid | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| CABELL HUNTINGTON HOSPITAL, INC Outpatient | Humana | Medicare | $116.82 | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Health Plan Of Nevada | Medicaid | $116.82 | — | — | 2026-05-14 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Selecthealth | Value Individual Aca | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Selecthealth | Signature Individual Aca | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Health Partners Of Nevada | Medicare Advantage | $116.82 | — | — | 2026-05-14 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Selecthealth | Medicare Advantage | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Health Partners Of Nevada | Medicare Advantage | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Selecthealth | Signature Individual Aca | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Molina | Medicare Advantage | $116.82 | — | — | 2026-05-14 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Humana | Medicare Choice Ppo | $116.82 | — | — | 2026-05-14 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Healthy U | Medicaid | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Molina | Medicare Choice Care Hmo | $116.82 | — | — | 2026-05-15 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Regence Bcbs | Medadvantage Ppo | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Health Plan Of Nevada | Medicaid | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Selecthealth | Medicaid | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Selecthealth | Medicare Advantage | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Health Partners Of Nevada | Medicare Advantage | $116.82 | — | — | 2026-05-14 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Molina | Medicaid | $116.82 | — | — | 2026-05-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Healthy U | Medicaid | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Selecthealth | Medicare Advantage | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Regence Bcbs | Medadvantage Ppo | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Uhc | Medicare Advantage | $116.82 | — | — | 2026-05-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Health Plan Of Nevada | Medicaid | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Health Partners Of Nevada | Medicare Advantage | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Selecthealth | Med Individual Aca | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Humana | Medicare Choice Ppo | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | American Health | Medicare Adv Ut Hmo I-Snp | $116.82 | — | — | 2026-05-15 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | American Health | Medicare Adv Ut Hmo I-Snp | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Aetna | Medicare Adv Hmo | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SPANISH FORK HOSPITAL Outpatient | Regence Bcbs | Medadvantage Ppo | $116.82 | — | — | 2026-05-15 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Molina | Medicaid | $116.82 | — | — | 2026-05-13 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Aetna | Medicare Adv Ppo | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| CABELL HUNTINGTON HOSPITAL, INC Outpatient | Aetna | Medicare | $116.82 | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH SPANISH FORK HOSPITAL Outpatient | Healthy U | Medicaid | $116.82 | — | — | 2026-05-15 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Selecthealth | Medicaid | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Uhc | Medicare Advantage | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Health Plan Of Nevada | Medicaid | $116.82 | — | — | 2026-05-14 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Humana | Medicare Choice Ppo | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Molina | Medicaid | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SPANISH FORK HOSPITAL Outpatient | Health Plan Of Nevada | Medicaid | $116.82 | — | — | 2026-05-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH SPANISH FORK HOSPITAL Outpatient | Health Partners Of Nevada | Medicare Advantage | $116.82 | — | — | 2026-05-15 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Molina | Medicare Complete Care Hmo Snp | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Aetna | Medicare Adv Ppo | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SPANISH FORK HOSPITAL Outpatient | Selecthealth | Med Individual Aca | $116.82 | — | — | 2026-05-15 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Molina | Medicare Complete Care Hmo Snp | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | American Health | Medicare Adv Ut Hmo I-Snp | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SPANISH FORK HOSPITAL Outpatient | Selecthealth | Signature Individual Aca | $116.82 | — | — | 2026-05-15 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Molina | Medicare Choice Care Hmo | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Molina | Medicare Advantage | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Molina | Medicare Complete Care Hmo Snp | $116.82 | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Aetna | Medicare Adv Ppo | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Aetna | Medicare Adv Hmo | $116.82 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Molina | Medicaid | $116.82 | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH SPANISH FORK HOSPITAL Outpatient | Selecthealth | Medicare Advantage | $116.82 | — | — | 2026-05-15 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Molina | Medicare Complete Care Hmo Snp | $116.82 | — | — | 2026-05-15 | 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.