4100008 — .man Diff Additional Charge 4100020
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). .MAN DIFF ADDITIONAL CHARGE 4100020 (OTHER 4100008) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/4100008?code_type=OTHER
MLA (9th ed.)
“.MAN DIFF ADDITIONAL CHARGE 4100020 (OTHER 4100008) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/4100008?code_type=OTHER. Accessed .
Chicago (notes-bibliography)
“.MAN DIFF ADDITIONAL CHARGE 4100020 (OTHER 4100008) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/4100008?code_type=OTHER.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $30–$387 (25th–75th percentile) across 7 hospitals · 58 payers.
“Negotiated” is the hospital’s negotiated facility rate for this OTHER 4100008 — 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 |
|---|---|---|---|---|---|---|---|
| HILLSDALE HOSPITAL Both | Aetna | Medicare Advantage | $3.61 | $39.00 | $33.15 | 2026-05-13 | MRF ↗ |
| HILLSDALE HOSPITAL Both | Thome Pace | Medicare Advantage | $3.61 | $39.00 | $33.15 | 2026-05-13 | MRF ↗ |
| HILLSDALE HOSPITAL Both | Cofinity | Commercial | $3.61 | $39.00 | $33.15 | 2026-05-13 | MRF ↗ |
| HILLSDALE HOSPITAL Both | Cigna | Commercial | $3.68 | $39.00 | $33.15 | 2026-05-06 | MRF ↗ |
| HILLSDALE HOSPITAL Both | Cigna | Commercial | $3.68 | $39.00 | $33.15 | 2026-05-13 | MRF ↗ |
| HILLSDALE HOSPITAL Both | Hap | Medicare Advantage | $3.80 | $39.00 | $33.15 | 2026-05-13 | MRF ↗ |
| HILLSDALE HOSPITAL Both | Priority Health | Medicare Advantage | $3.80 | $39.00 | $33.15 | 2026-05-13 | MRF ↗ |
| HILLSDALE HOSPITAL Both | Priority Health | Medicare Advantage | $3.80 | $39.00 | $33.15 | 2026-05-06 | MRF ↗ |
| HILLSDALE HOSPITAL Both | United Healthcare | Medicare Advantage | $3.80 | $39.00 | $33.15 | 2026-05-13 | MRF ↗ |
| HILLSDALE HOSPITAL Both | Medicare | Medicare | $3.80 | $39.00 | $33.15 | 2026-05-13 | MRF ↗ |
| HILLSDALE HOSPITAL Both | Humana | Medicare Advantage | $3.80 | $39.00 | $33.15 | 2026-05-13 | MRF ↗ |
| HILLSDALE HOSPITAL Both | Humana | Medicare Advantage | $3.80 | $39.00 | $33.15 | 2026-05-06 | MRF ↗ |
| HILLSDALE HOSPITAL Both | Amerigroup | Medicare Advantage | $3.80 | $39.00 | $33.15 | 2026-05-13 | MRF ↗ |
| HILLSDALE HOSPITAL Both | Amerigroup | Medicare Advantage | $3.80 | $39.00 | $33.15 | 2026-05-06 | MRF ↗ |
| HILLSDALE HOSPITAL Both | Medicare | Medicare | $3.80 | $39.00 | $33.15 | 2026-05-06 | MRF ↗ |
| HILLSDALE HOSPITAL Both | United Healthcare | Medicare Advantage | $3.80 | $39.00 | $33.15 | 2026-05-06 | MRF ↗ |
| HILLSDALE HOSPITAL Both | Hap | Medicare | $3.80 | $39.00 | $33.15 | 2026-05-06 | MRF ↗ |
| HILLSDALE HOSPITAL Both | Bcbs | Medicare Advantage | $3.80 | $39.00 | $33.15 | 2026-05-06 | MRF ↗ |
| HILLSDALE HOSPITAL Both | Bcbs | Medicare Advantage | $3.80 | $39.00 | $33.15 | 2026-05-13 | MRF ↗ |
| HILLSDALE HOSPITAL Both | Wellpath | Medicaid | $3.80 | $39.00 | $33.15 | 2026-05-06 | MRF ↗ |
| HILLSDALE HOSPITAL Both | Aetna | Medicare Advantage | $3.80 | $39.00 | $33.15 | 2026-05-06 | MRF ↗ |
| HILLSDALE HOSPITAL Both | Vcpg | Medicaid | $4.75 | $39.00 | $33.15 | 2026-05-13 | MRF ↗ |
| HILLSDALE HOSPITAL Both | Nomi Hsa | Commercial | $5.70 | $39.00 | $33.15 | 2026-05-13 | MRF ↗ |
| HILLSDALE HOSPITAL Both | Uhc | Medicaid | $21.33 | $39.00 | $33.15 | 2026-05-06 | MRF ↗ |
| HILLSDALE HOSPITAL Both | Meridian Health Plan | Medicaid | $21.33 | $39.00 | $33.15 | 2026-05-06 | MRF ↗ |
| HILLSDALE HOSPITAL Both | Bcbs | Medicaid | $21.33 | $39.00 | $33.15 | 2026-05-06 | MRF ↗ |
| HILLSDALE HOSPITAL Both | Paramount | Mi Hmo | $21.45 | $39.00 | $33.15 | 2026-05-06 | MRF ↗ |
| HILLSDALE HOSPITAL Both | Paramount | Mi Hmo | $21.84 | $39.00 | $33.15 | 2026-05-13 | MRF ↗ |
| HILLSDALE HOSPITAL Both | Bcbs | Commercial | $24.48 | $39.00 | $33.15 | 2026-05-13 | MRF ↗ |
| HILLSDALE HOSPITAL Both | Bcbs | Commercial | $26.24 | $39.00 | $33.15 | 2026-05-06 | MRF ↗ |
| HILLSDALE HOSPITAL Both | Front Path | Commercial | $27.69 | $39.00 | $33.15 | 2026-05-13 | MRF ↗ |
| HILLSDALE HOSPITAL Both | Front Path | Commercial | $27.69 | $39.00 | $33.15 | 2026-05-06 | MRF ↗ |
| HILLSDALE HOSPITAL Both | Mclaren | All Commercial Plans | $29.25 | $39.00 | $33.15 | 2026-05-06 | MRF ↗ |
| HILLSDALE HOSPITAL Both | Hap | All Commercial | $29.25 | $39.00 | $33.15 | 2026-05-06 | MRF ↗ |
| HILLSDALE HOSPITAL Both | Mclaren | All Commercial | $29.25 | $39.00 | $33.15 | 2026-05-13 | MRF ↗ |
| HILLSDALE HOSPITAL Both | Hap | All Commercial | $29.25 | $39.00 | $33.15 | 2026-05-13 | MRF ↗ |
| HILLSDALE HOSPITAL Both | Priority Health | All Commercial Plans | $30.23 | $39.00 | $33.15 | 2026-05-06 | MRF ↗ |
| HILLSDALE HOSPITAL Both | Priority Health | All Commercial | $30.23 | $39.00 | $33.15 | 2026-05-13 | MRF ↗ |
| HILLSDALE HOSPITAL Both | Paramount | Ppo | $30.81 | $39.00 | $33.15 | 2026-05-06 | MRF ↗ |
| HILLSDALE HOSPITAL Both | Paramount | Oh Hmo | $30.81 | $39.00 | $33.15 | 2026-05-06 | MRF ↗ |
| HILLSDALE HOSPITAL Both | United Healthcare | Commercial | $31.20 | $39.00 | $33.15 | 2026-05-13 | MRF ↗ |
| HILLSDALE HOSPITAL Both | United Healthcare | Commercial | $31.20 | $39.00 | $33.15 | 2026-05-06 | MRF ↗ |
| HILLSDALE HOSPITAL Both | Paramount | Oh Hmo And Ppo | $31.59 | $39.00 | $33.15 | 2026-05-13 | MRF ↗ |
| HILLSDALE HOSPITAL Both | Aetna | Commercial | $31.94 | $39.00 | $33.15 | 2026-05-06 | MRF ↗ |
| HILLSDALE HOSPITAL Both | Aetna | Commercial | $31.94 | $39.00 | $33.15 | 2026-05-13 | MRF ↗ |
| HILLSDALE HOSPITAL Both | Cofinity | Commercial | $35.10 | $39.00 | $33.15 | 2026-05-06 | MRF ↗ |
| HILLSDALE HOSPITAL Both | Multiplan | Commercial | $37.05 | $39.00 | $33.15 | 2026-05-06 | MRF ↗ |
| HILLSDALE HOSPITAL Both | Multiplan | Commercial | $37.05 | $39.00 | $33.15 | 2026-05-13 | MRF ↗ |
| CRESCENT MEDICAL CENTER LANCASTER | Aetna Commercial Health | — | $42.98 | $279.80 | — | 2026-08-01 | MRF ↗ |
| CRESCENT MEDICAL CENTER LANCASTER | Aetna Workerscomp | — | $42.98 | $279.80 | — | 2026-08-01 | MRF ↗ |
| CRESCENT MEDICAL CENTER LANCASTER | Superiorhealthcare Ambetter Wellcare Allwell Star_Star+Plus_Starkids_Chip_Chip Perinate_Star Health | — | $52.87 | $279.80 | — | 2026-08-01 | MRF ↗ |
| CRESCENT MEDICAL CENTER LANCASTER | Cigna Healthsprings Medicaid | — | $52.87 | $279.80 | — | 2026-08-01 | MRF ↗ |
| CRESCENT MEDICAL CENTER LANCASTER | United Healthcare Medicaid/Chip | — | $52.87 | $279.80 | — | 2026-08-01 | MRF ↗ |
| CRESCENT MEDICAL CENTER LANCASTER | Texas Medicaid Health Plan | — | $52.87 | $279.80 | — | 2026-08-01 | MRF ↗ |
| CRESCENT MEDICAL CENTER LANCASTER | Amerigroup Medicaid | — | $52.87 | $279.80 | — | 2026-08-01 | MRF ↗ |
| CRESCENT MEDICAL CENTER LANCASTER | Multiplan Medicare Advantage | — | $55.71 | $279.80 | — | 2026-08-01 | MRF ↗ |
| CRESCENT MEDICAL CENTER LANCASTER | Choice Care Humana Medicare Medicare Network Private Fee For Service Plan | — | $56.85 | $279.80 | — | 2026-08-01 | MRF ↗ |
| CRESCENT MEDICAL CENTER LANCASTER | Superiorhealthcare Ambetter Wellcare Allwell Commercial | — | $56.85 | $279.80 | — | 2026-08-01 | MRF ↗ |
| CRESCENT MEDICAL CENTER LANCASTER | Medicare Traditional | — | $56.85 | $279.80 | — | 2026-08-01 | MRF ↗ |
| CRESCENT MEDICAL CENTER LANCASTER | United Healthcare Medicare Advantage | — | $56.85 | $279.80 | — | 2026-08-01 | MRF ↗ |
| CRESCENT MEDICAL CENTER LANCASTER | Aetna Medicare | — | $56.85 | $279.80 | — | 2026-08-01 | MRF ↗ |
| CRESCENT MEDICAL CENTER LANCASTER | Wellmed(Uhc) Hmo/Ppo Medicare Advantage Plans | — | $56.85 | $279.80 | — | 2026-08-01 | MRF ↗ |
| OWENSBORO HEALTH TWIN LAKES MEDICAL CENTER | Anthem_Exchange | — | $64.93 | $89.00 | $44.50 | 2026-07-31 | MRF ↗ |
| CRESCENT MEDICAL CENTER LANCASTER | Molina Healthcare Of Texas Healthbenefitexchange Healthinsurance Marketplace | — | $67.08 | $279.80 | — | 2026-08-01 | MRF ↗ |
| OWENSBORO HEALTH TWIN LAKES MEDICAL CENTER | Anthem_Exchange | — | $67.41 | $89.00 | $44.50 | 2026-07-31 | MRF ↗ |
| OWENSBORO HEALTH TWIN LAKES MEDICAL CENTER | Anthem_Commercial-All_Other_Plans | — | $68.35 | $89.00 | $44.50 | 2026-07-31 | MRF ↗ |
| OWENSBORO HEALTH TWIN LAKES MEDICAL CENTER | Humana-All_Plans | — | $69.72 | $89.00 | $44.50 | 2026-07-31 | MRF ↗ |
| OWENSBORO HEALTH TWIN LAKES MEDICAL CENTER | Anthem_Commercial-All_Other_Plans | — | $70.96 | $89.00 | $44.50 | 2026-07-31 | MRF ↗ |
| OWENSBORO HEALTH TWIN LAKES MEDICAL CENTER | Center_Care_Aetna | — | $73.87 | $89.00 | $44.50 | 2026-07-31 | MRF ↗ |
| OWENSBORO HEALTH TWIN LAKES MEDICAL CENTER | Center_Care_Cigna | — | $73.87 | $89.00 | $44.50 | 2026-07-31 | MRF ↗ |
| OWENSBORO HEALTH TWIN LAKES MEDICAL CENTER | Multiplan-All_Plans | — | $78.32 | $89.00 | $44.50 | 2026-07-31 | MRF ↗ |
| BROOKINGS HEALTH SYSTEM Outpatient | Medica Msho | Commercial | $104.15 | $265.00 | $132.50 | 2026-05-14 | MRF ↗ |
| BROOKINGS HEALTH SYSTEM Outpatient | Medica Choice Care | Commercial | $106.53 | $265.00 | $132.50 | 2026-05-14 | MRF ↗ |
| CRESCENT MEDICAL CENTER LANCASTER | Bluecross Blueshield Of Tx_ Bav/Hmo | — | $134.30 | $279.80 | — | 2026-08-01 | MRF ↗ |
| BROOKINGS HEALTH SYSTEM Outpatient | Medica Medicare Adv | Medicare | $138.05 | $265.00 | $132.50 | 2026-05-14 | MRF ↗ |
| BROOKINGS HEALTH SYSTEM Outpatient | Medicare And Medicare Adv | Medicare | $138.05 | $265.00 | $132.50 | 2026-05-14 | MRF ↗ |
| CRESCENT MEDICAL CENTER LANCASTER | Bluecross Blueshield Of Tx_ Blueessentials | — | $151.09 | $279.80 | — | 2026-08-01 | MRF ↗ |
| CRESCENT MEDICAL CENTER LANCASTER | Bluecross Blueshield Of Tx_Traditional | — | $167.88 | $279.80 | — | 2026-08-01 | MRF ↗ |
| CRESCENT MEDICAL CENTER LANCASTER | Bluecross Blueshield Of Tx_Ppo | — | $167.88 | $279.80 | — | 2026-08-01 | MRF ↗ |
| BROOKINGS HEALTH SYSTEM Outpatient | Medica | Commercial | $193.98 | $265.00 | $132.50 | 2026-05-14 | MRF ↗ |
| BROOKINGS HEALTH SYSTEM Outpatient | Medica Accessibility Solution | Commercial | $193.98 | $265.00 | $132.50 | 2026-05-14 | MRF ↗ |
| BROOKINGS HEALTH SYSTEM Outpatient | Medica Selectcare | Commercial | $193.98 | $265.00 | $132.50 | 2026-05-14 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Humana Employers Health | Commercial | $198.00 | $1,320.00 | $1,056.00 | 2026-05-08 | MRF ↗ |
| BROOKINGS HEALTH SYSTEM Outpatient | Uhc | Commercial | $219.42 | $265.00 | $132.50 | 2026-05-14 | MRF ↗ |
| BROOKINGS HEALTH SYSTEM Outpatient | Bcbs | Commercial | $228.85 | $265.00 | $132.50 | 2026-05-14 | MRF ↗ |
| BROOKINGS HEALTH SYSTEM Outpatient | Humana | Commercial | $238.50 | $265.00 | $132.50 | 2026-05-14 | MRF ↗ |
| BROOKINGS HEALTH SYSTEM Outpatient | Avera | Commercial | $238.50 | $265.00 | $132.50 | 2026-05-14 | MRF ↗ |
| BROOKINGS HEALTH SYSTEM Outpatient | Sanford Bhcag | Commercial | $251.75 | $265.00 | $132.50 | 2026-05-14 | MRF ↗ |
| BROOKINGS HEALTH SYSTEM Outpatient | Multiplan | Commercial | $257.05 | $265.00 | $132.50 | 2026-05-14 | MRF ↗ |
| BROOKINGS HEALTH SYSTEM Outpatient | Medicaid | Medicaid | $265.00 | $265.00 | $132.50 | 2026-05-14 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Collective Health | Commercial | $314.29 | $1,320.00 | $1,056.00 | 2026-05-08 | MRF ↗ |
| ALLENDALE COUNTY HOSPITAL Both | Freedom Health | Medicare | $330.00 | $750.00 | $637.50 | 2026-05-06 | MRF ↗ |
| ALLENDALE COUNTY HOSPITAL Both | Healthsun Health | Medicare | $330.00 | $750.00 | $637.50 | 2026-05-06 | MRF ↗ |
| ALLENDALE COUNTY HOSPITAL Both | Humana Gold | Medicare | $330.00 | $750.00 | $637.50 | 2026-05-06 | MRF ↗ |
| ALLENDALE COUNTY HOSPITAL Both | Devoted Health | Medicare | $330.00 | $750.00 | $637.50 | 2026-05-06 | MRF ↗ |
| ALLENDALE COUNTY HOSPITAL Both | United Healthcare Medicare Solutions | Medicare | $330.00 | $750.00 | $637.50 | 2026-05-06 | MRF ↗ |
| ALLENDALE COUNTY HOSPITAL Both | Pruitt Health Premier | Medicare | $330.00 | $750.00 | $637.50 | 2026-05-06 | MRF ↗ |
| ALLENDALE COUNTY HOSPITAL Both | Emblem Health | Medicare | $330.00 | $750.00 | $637.50 | 2026-05-06 | MRF ↗ |
| ALLENDALE COUNTY HOSPITAL Both | Eon Health | Medicare | $330.00 | $750.00 | $637.50 | 2026-05-06 | MRF ↗ |
| ALLENDALE COUNTY HOSPITAL Both | Aetna Medicare Open | Medicare | $330.00 | $750.00 | $637.50 | 2026-05-06 | MRF ↗ |
| ALLENDALE COUNTY HOSPITAL Both | Allwell Medicare | Medicare | $330.00 | $750.00 | $637.50 | 2026-05-06 | MRF ↗ |
| ALLENDALE COUNTY HOSPITAL Both | Wellcare Medicare Advantage | Medicare | $330.00 | $750.00 | $637.50 | 2026-05-06 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Bcbs Hmo Bav Advantage | Commercial | $349.21 | $1,320.00 | $1,056.00 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Aetna Medicare | Medicare | $382.80 | $1,320.00 | $1,056.00 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Tricare North Region | Medicare | $382.80 | $1,320.00 | $1,056.00 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Tricare Wps Vac3 | Medicare | $382.80 | $1,320.00 | $1,056.00 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Tricare West Region | Medicare | $382.80 | $1,320.00 | $1,056.00 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Tricare East | Medicare | $382.80 | $1,320.00 | $1,056.00 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Humana Medicare Advantage | Medicare | $386.63 | $1,320.00 | $1,056.00 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | United Healthcarevrr Medicare | Medicare | $386.63 | $1,320.00 | $1,056.00 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Humana Gold Plus Medicare | Medicare | $386.63 | $1,320.00 | $1,056.00 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | United Healthcare Medicare | Medicare | $386.63 | $1,320.00 | $1,056.00 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Humana Medicare Gold Choice | Medicare | $386.63 | $1,320.00 | $1,056.00 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Cigna | Commercial | $726.00 | $1,320.00 | $1,056.00 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Cigna Healthsmart | Commercial | $726.00 | $1,320.00 | $1,056.00 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Cigna Health Care Tx | Commercial | $726.00 | $1,320.00 | $1,056.00 | 2026-05-08 | MRF ↗ |
| CRESCENT MEDICAL CENTER LANCASTER | Cigna Healthsprings Medicare Advantage | — | $781.88 | $279.80 | — | 2026-08-01 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Aetna Hmo | Commercial | $990.00 | $1,320.00 | $1,056.00 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Insurance Management Service | Commercial | $990.00 | $1,320.00 | $1,056.00 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Aetna Ppo | Commercial | $990.00 | $1,320.00 | $1,056.00 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Allied Group Insurance | Commercial | $990.00 | $1,320.00 | $1,056.00 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Bcbs Of Texas | Commercial | $1,056.00 | $1,320.00 | $1,056.00 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | First Care Hmo | Commercial | $1,056.00 | $1,320.00 | $1,056.00 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Allied Benefit Mchd Employee | Commercial | $1,122.00 | $1,320.00 | $1,056.00 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | First Health | Commercial | $1,122.00 | $1,320.00 | $1,056.00 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | First Care Ppo | Commercial | $1,188.00 | $1,320.00 | $1,056.00 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Geha | Commercial | $1,188.00 | $1,320.00 | $1,056.00 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Umr | Commercial | $1,188.00 | $1,320.00 | $1,056.00 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Golden Rule Insurance In | Commercial | $1,188.00 | $1,320.00 | $1,056.00 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Tml Iebp | Commercial | $1,188.00 | $1,320.00 | $1,056.00 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | United Healthcare | Commercial | $1,188.00 | $1,320.00 | $1,056.00 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Ntca Benefit Ppo | Commercial | $1,188.00 | $1,320.00 | $1,056.00 | 2026-05-08 | MRF ↗ |
| SELF REGIONAL HEALTHCARE | Molina Medicare | — | $1,490.96 | $8,111.88 | $4,867.13 | 2026-07-17 | MRF ↗ |
| SELF REGIONAL HEALTHCARE | Molina Marketplace | — | $1,622.38 | $8,111.88 | $4,867.13 | 2026-07-17 | MRF ↗ |
| SELF REGIONAL HEALTHCARE | Blue Cross Blue Shield Marketplace | — | $1,851.26 | $8,111.88 | $4,867.13 | 2026-07-17 | MRF ↗ |
| SELF REGIONAL HEALTHCARE | Humana Medicare | — | $1,885.01 | $8,111.88 | $4,867.13 | 2026-07-17 | MRF ↗ |
| SELF REGIONAL HEALTHCARE | Wellcare Medicare | — | $1,941.35 | $8,111.88 | $4,867.13 | 2026-07-17 | MRF ↗ |
| SELF REGIONAL HEALTHCARE | Aetna Medicare | — | $2,061.90 | $8,111.88 | $4,867.13 | 2026-07-17 | MRF ↗ |
| SELF REGIONAL HEALTHCARE | Atc Medicare | — | $2,306.75 | $8,111.88 | $4,867.13 | 2026-07-17 | MRF ↗ |
| SELF REGIONAL HEALTHCARE | Molina Healthy Connection Prime | — | $2,371.47 | $8,111.88 | $4,867.13 | 2026-07-17 | MRF ↗ |
| SELF REGIONAL HEALTHCARE | Atc Medicaid | — | $2,452.54 | $8,111.88 | $4,867.13 | 2026-07-17 | MRF ↗ |
| SELF REGIONAL HEALTHCARE | Blue Cross Blue Shield Medicare | — | $2,549.80 | $8,111.88 | $4,867.13 | 2026-07-17 | MRF ↗ |
| SELF REGIONAL HEALTHCARE | Select Medicaid | — | $3,049.67 | $8,111.88 | $4,867.13 | 2026-07-17 | MRF ↗ |
| SELF REGIONAL HEALTHCARE | Molina Medicaid | — | $3,196.38 | $8,111.88 | $4,867.13 | 2026-07-17 | MRF ↗ |
| SELF REGIONAL HEALTHCARE | Wellcare Medicaid | — | $3,377.81 | $8,111.88 | $4,867.13 | 2026-07-17 | MRF ↗ |
| SELF REGIONAL HEALTHCARE | Bluechoice Medicaid | — | $3,513.96 | $8,111.88 | $4,867.13 | 2026-07-17 | MRF ↗ |