3617286 — 2102-2205 Vitoss Foam Pack 5cc
Cite this view
HANK Price Transparency. (n.d.). 2102-2205 Vitoss Foam Pack 5cc (CDM 3617286) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/3617286?code_type=CDM
“2102-2205 Vitoss Foam Pack 5cc (CDM 3617286) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/3617286?code_type=CDM. Accessed .
“2102-2205 Vitoss Foam Pack 5cc (CDM 3617286) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/3617286?code_type=CDM.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $4,978–$5,144 (25th–75th percentile) across 1 hospital · 11 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CDM 3617286 — 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 VALLEY REGIONAL MEDICAL CENTER Outpatient | United Healthcare Insurance Company | Medicare Advantage | $1,659.00 | $5,531.00 | $3,319.00 | 2026-07-15 | MRF ↗ |
| ARKANSAS VALLEY REGIONAL MEDICAL CENTER Outpatient | Kaiser Permanente Insurance Company | Medicare Advantage | $1,715.00 | $5,531.00 | $3,319.00 | 2026-07-15 | MRF ↗ |
| ARKANSAS VALLEY REGIONAL MEDICAL CENTER Outpatient | Blue Cross Blue Shield | Commercial | $4,812.00 | $5,531.00 | $3,319.00 | 2026-07-15 | MRF ↗ |
| ARKANSAS VALLEY REGIONAL MEDICAL CENTER Outpatient | Humana Inc. | Commercial | $4,978.00 | $5,531.00 | $3,319.00 | 2026-07-15 | MRF ↗ |
| ARKANSAS VALLEY REGIONAL MEDICAL CENTER Outpatient | Muti-Plan | Commercial | $4,978.00 | $5,531.00 | $3,319.00 | 2026-07-15 | MRF ↗ |
| ARKANSAS VALLEY REGIONAL MEDICAL CENTER Outpatient | Meritain Health | Commercial | $4,978.00 | $5,531.00 | $3,319.00 | 2026-07-15 | MRF ↗ |
| ARKANSAS VALLEY REGIONAL MEDICAL CENTER Outpatient | Aetna | Commercial | $4,978.00 | $5,531.00 | $3,319.00 | 2026-07-15 | MRF ↗ |
| ARKANSAS VALLEY REGIONAL MEDICAL CENTER Outpatient | Kaiser Permanente Insurance Company | Commercial | $4,978.00 | $5,531.00 | $3,319.00 | 2026-07-15 | MRF ↗ |
| ARKANSAS VALLEY REGIONAL MEDICAL CENTER Outpatient | America | PPO | $4,978.00 | $5,531.00 | $3,319.00 | 2026-07-15 | MRF ↗ |
| ARKANSAS VALLEY REGIONAL MEDICAL CENTER Outpatient | Rocky Mountain Hospital & Medical | Commercial | $5,144.00 | $5,531.00 | $3,319.00 | 2026-07-15 | MRF ↗ |
| ARKANSAS VALLEY REGIONAL MEDICAL CENTER Outpatient | Select Health | Commercial | $5,254.00 | $5,531.00 | $3,319.00 | 2026-07-15 | MRF ↗ |
| ARKANSAS VALLEY REGIONAL MEDICAL CENTER Outpatient | Cigna Health and Life Insurance Co | Commercial | $5,254.00 | $5,531.00 | $3,319.00 | 2026-07-15 | MRF ↗ |
| ARKANSAS VALLEY REGIONAL MEDICAL CENTER Outpatient | Blue Cross Blue Shield | Medicare Advantage | $5,531.00 | $5,531.00 | $3,319.00 | 2026-07-15 | MRF ↗ |