4202315701 — Ethacrynate Sodium 50 Mg Intravenous Solution
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION (NDC 4202315701) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/4202315701?code_type=NDC
MLA (9th ed.)
“ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION (NDC 4202315701) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/4202315701?code_type=NDC. Accessed .
Chicago (notes-bibliography)
“ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION (NDC 4202315701) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/4202315701?code_type=NDC.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $3,556–$10,260 (25th–75th percentile) across 17 hospitals · 168 payers.
“Negotiated” is the hospital’s negotiated facility rate for this NDC 4202315701 — 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 |
|---|---|---|---|---|---|---|---|
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | CAPITAL BLUE CROSS | MEDICARE ADVANTAGE | $18.27 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | CAPITAL BLUE CROSS | MEDICARE ADVANTAGE | $18.27 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | CAPITAL BLUE CROSS | MEDICARE ADVANTAGE | $18.27 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | HUMANA | MEDICARE ADVANTAGE | $18.45 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | HUMANA | MEDICARE ADVANTAGE | $18.45 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | HIGHMARK BLUE SHIELD | MEDICARE ADVANTAGE | $18.64 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | GEISINGER | MEDICARE ADVANTAGE | $18.64 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | HIGHMARK BLUE SHIELD | MEDICARE ADVANTAGE | $18.64 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | HIGHMARK BLUE SHIELD | MEDICARE ADVANTAGE | $18.64 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | CIGNA | HEALTHSPRING | $18.82 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | GEISINGER | MEDICARE ADVANTAGE | $18.82 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | CIGNA | HEALTHSPRING | $18.82 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | CIGNA | HEALTHSPRING | $18.82 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | GEISINGER | MEDICARE ADVANTAGE | $18.82 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | AMERIHEALTH | MEDICARE ADVANTAGE | $19.18 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | AETNA | MEDICARE ADVANTAGE | $19.18 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | DEVOTED HEALTH | MEDICARE ADVANTAGE | $19.18 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | JEFFERSON HEALTH PARTNERS | MEDICARE ADVANTAGE | $19.18 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | HUMANA | MEDICARE ADVANTAGE | $19.18 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | JEFFERSON HEALTH PARTNERS | MEDICARE ADVANTAGE | $19.18 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | AETNA | MEDICARE ADVANTAGE | $19.18 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | AMERIHEALTH | MEDICARE ADVANTAGE | $19.18 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | AETNA | MEDICARE ADVANTAGE | $19.18 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | AMERIHEALTH | MEDICARE ADVANTAGE | $19.18 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | JEFFERSON HEALTH PARTNERS | MEDICARE ADVANTAGE | $19.18 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | UPMC | MEDICARE ADVANTAGE | $19.37 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | UPMC | MEDICARE ADVANTAGE | $19.37 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | UPMC | MEDICARE ADVANTAGE | $19.37 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | EMBLEM | MEDICARE ADVANTAGE | $19.73 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | EMBLEM | MEDICARE ADVANTAGE | $19.73 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | EMBLEM | MEDICARE ADVANTAGE | $19.73 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | GATEWAY | MEDICARE ADVANTAGE | $19.91 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | GATEWAY | MEDICARE ADVANTAGE | $19.91 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | GATEWAY | MEDICARE ADVANTAGE | $19.91 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | PA HEALTH & WELLNESS (ALLWELL) | MEDICARE ADVANTAGE | $20.10 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | PA HEALTH & WELLNESS (ALLWELL) | MEDICARE ADVANTAGE | $20.10 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | PA HEALTH & WELLNESS (ALLWELL) | MEDICARE ADVANTAGE | $20.10 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | UPMC | SNP | $23.07 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | UPMC | SNP | $23.07 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | UPMC | SNP | $23.07 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | HIGHMARK BLUE SHIELD | CHIP | $43.59 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | GEISINGER | MARKETPLACE | $44.37 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | GEISINGER | MARKETPLACE | $44.37 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | GEISINGER | ALL PRODUCTS | $46.24 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | MESHOPPEN STONE | ALL PRODUCTS | $51.16 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | MESHOPPEN STONE | ALL PRODUCTS | $51.16 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | MESHOPPEN STONE | ALL PRODUCTS | $51.16 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | CAPITAL BLUE CROSS | CHIP | $51.68 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | CAPITAL BLUE CROSS | CHIP | $51.68 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | HIGHMARK BLUE SHIELD | TIERED PRODUCTS (COALITION) | $51.70 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | HIGHMARK BLUE SHIELD | ALL PRODUCTS | $51.70 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | HIGHMARK BLUE SHIELD | CHIP | $51.70 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | HIGHMARK BLUE SHIELD | CHIP | $51.70 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | HIGHMARK BLUE SHIELD | ACA NARROW NETWORK | $51.70 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | HIGHMARK BLUE SHIELD | ACA NARROW NETWORK | $51.70 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | HIGHMARK BLUE SHIELD | ALL PRODUCTS | $51.70 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | HIGHMARK BLUE SHIELD | TIERED PRODUCTS (COALITION) | $51.70 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | HIGHMARK BLUE SHIELD | ACA NARROW NETWORK | $52.88 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | HIGHMARK BLUE SHIELD | TIERED PRODUCTS (COALITION) | $52.98 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | CAPITAL BLUE CROSS | CHIP | $52.99 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | AMBETTER | ALL PRODUCTS | $55.41 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | AMBETTER | ALL PRODUCTS | $55.41 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | AMBETTER | ALL PRODUCTS | $55.41 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | HIGHMARK BLUE SHIELD | ALL PRODUCTS | $58.86 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| TRINITY HEALTH OAKLAND HOSPITAL OutpatientFacility | Molina | Medicare Advantage | $75.00 | $17,476.20 | $11,359.53 | 2025-01-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | AETNA | PEBTF | $75.66 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | AETNA | PEBTF | $75.66 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | CAPITAL BLUE CROSS | ALL PRODUCTS | $75.70 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | GEISINGER | ALL PRODUCTS | $83.80 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | GEISINGER | ALL PRODUCTS | $83.80 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | CAPITAL BLUE CROSS | ALL PRODUCTS | $87.59 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | CAPITAL BLUE CROSS | ALL PRODUCTS | $87.59 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | UPMC | ALL PRODUCTS | $88.97 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | UPMC | ALL PRODUCTS | $88.97 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | UPMC | ALL PRODUCTS | $88.97 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | AETNA | ALL PRODUCTS | $95.77 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | AETNA | ALL PRODUCTS | $95.77 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | AETNA | ALL PRODUCTS | $106.39 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | VALLEY PREFERRED | ALL PRODUCTS | $111.17 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | VALLEY PREFERRED | ALL PRODUCTS | $111.17 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | VALLEY PREFERRED | ALL PRODUCTS | $111.17 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | POPULYTICS | ALL PRODUCTS | $141.58 | $1,042.54 | $521.27 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | POPULYTICS | ALL PRODUCTS | $141.58 | $1,042.54 | $521.27 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | POPULYTICS | ALL PRODUCTS | $142.32 | $1,048.04 | $524.02 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | POPULYTICS | ALL PRODUCTS | $142.32 | $1,048.04 | $524.02 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | EMBLEM | ALL PRODUCTS | $145.96 | $1,042.54 | $521.27 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | EMBLEM | ALL PRODUCTS | $145.96 | $1,042.54 | $521.27 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | EMBLEM | ALL PRODUCTS | $145.96 | $1,042.54 | $521.27 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | EMBLEM | ALL PRODUCTS | $146.73 | $1,048.04 | $524.02 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | EMBLEM | ALL PRODUCTS | $146.73 | $1,048.04 | $524.02 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | EMBLEM | ALL PRODUCTS | $146.73 | $1,048.04 | $524.02 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | POPULYTICS | ALL PRODUCTS | $179.94 | $1,042.54 | $521.27 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | POPULYTICS | ALL PRODUCTS | $179.94 | $1,042.54 | $521.27 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | POPULYTICS | ALL PRODUCTS | $180.89 | $1,048.04 | $524.02 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | POPULYTICS | ALL PRODUCTS | $180.89 | $1,048.04 | $524.02 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | AETNA | MANAGED MEDICAID | $187.66 | $1,042.54 | $521.27 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | AETNA | MANAGED MEDICAID | $187.66 | $1,042.54 | $521.27 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | AETNA | MANAGED MEDICAID | $187.66 | $1,042.54 | $521.27 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | AETNA | MANAGED MEDICAID | $188.65 | $1,048.04 | $524.02 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | AETNA | MANAGED MEDICAID | $188.65 | $1,048.04 | $524.02 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | AETNA | MANAGED MEDICAID | $188.65 | $1,048.04 | $524.02 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | UNITED HEALTHCARE | CHIP | $208.51 | $1,042.54 | $521.27 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $208.51 | $1,042.54 | $521.27 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $209.61 | $1,048.04 | $524.02 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | UNITED HEALTHCARE | CHIP | $209.61 | $1,048.04 | $524.02 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | POPULYTICS | ALL PRODUCTS | $286.78 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | POPULYTICS | ALL PRODUCTS | $286.78 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | EMBLEM | ALL PRODUCTS | $295.65 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | EMBLEM | ALL PRODUCTS | $295.65 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | EMBLEM | ALL PRODUCTS | $295.65 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | POPULYTICS | ALL PRODUCTS | $337.37 | $1,042.54 | $521.27 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | POPULYTICS | ALL PRODUCTS | $339.15 | $1,048.04 | $524.02 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | POPULYTICS | ALL PRODUCTS | $364.50 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | POPULYTICS | ALL PRODUCTS | $364.50 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $364.89 | $1,042.54 | $521.27 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $364.89 | $1,042.54 | $521.27 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $364.89 | $1,042.54 | $521.27 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $366.81 | $1,048.04 | $524.02 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $366.81 | $1,048.04 | $524.02 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $366.81 | $1,048.04 | $524.02 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | AETNA | MANAGED MEDICAID | $380.12 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | AETNA | MANAGED MEDICAID | $380.12 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | AETNA | MANAGED MEDICAID | $380.12 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | UNITED HEALTHCARE | CHIP | $422.36 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $422.36 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | UNITED HEALTHCARE | ALL PRODUCTS | $519.18 | $1,042.54 | $521.27 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | CIGNA | ALL PRODUCTS | $521.27 | $1,042.54 | $521.27 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | CIGNA | ALL PRODUCTS | $521.27 | $1,042.54 | $521.27 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | UNITED HEALTHCARE | ALL PRODUCTS | $521.92 | $1,048.04 | $524.02 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | CIGNA | ALL PRODUCTS | $524.02 | $1,048.04 | $524.02 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | CIGNA | ALL PRODUCTS | $524.02 | $1,048.04 | $524.02 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | POPULYTICS | ALL PRODUCTS | $683.38 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | CIGNA | ALL PRODUCTS | $722.48 | $1,042.54 | $521.27 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | CIGNA | ALL PRODUCTS | $726.29 | $1,048.04 | $524.02 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $739.13 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $739.13 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $739.13 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | Aetna | Managed Medicaid | $866.20 | $5,218.08 | — | 2024-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | AETNA | MANAGED MEDICAID | $866.20 | $5,218.08 | — | 2025-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | AETNA | MANAGED MEDICAID | $866.20 | $5,218.08 | — | 2025-12-31 | MRF ↗ |
| SOUTHERN OCEAN MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $939.25 | $5,218.08 | — | 2025-12-31 | MRF ↗ |
| Hackensack University Medical Center OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $939.25 | $5,218.08 | — | 2025-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $939.25 | $5,218.08 | — | 2025-12-31 | MRF ↗ |
| Hackensack University Medical Center OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $939.25 | $5,218.08 | — | 2025-12-31 | MRF ↗ |
| SOUTHERN OCEAN MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $939.25 | $5,218.08 | — | 2025-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $939.25 | $5,218.08 | — | 2024-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $939.25 | $5,218.08 | — | 2025-12-31 | MRF ↗ |
| SOUTHERN OCEAN MEDICAL CENTER OutpatientFacility | AETNA | MANAGED MEDICAID | $965.34 | $5,218.08 | — | 2025-12-31 | MRF ↗ |
| SOUTHERN OCEAN MEDICAL CENTER OutpatientFacility | AETNA | MANAGED MEDICAID | $965.34 | $5,218.08 | — | 2025-12-31 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | UNITED HEALTHCARE | ALL PRODUCTS | $1,051.68 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | CIGNA | ALL PRODUCTS | $1,055.90 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | CIGNA | ALL PRODUCTS | $1,055.90 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| SOUTHERN OCEAN MEDICAL CENTER OutpatientFacility | SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,069.71 | $5,218.08 | — | 2025-12-31 | MRF ↗ |
| SOUTHERN OCEAN MEDICAL CENTER OutpatientFacility | SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,069.71 | $5,218.08 | — | 2025-12-31 | MRF ↗ |
| SOUTHERN OCEAN MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $1,090.58 | $5,218.08 | — | 2025-12-31 | MRF ↗ |
| SOUTHERN OCEAN MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $1,090.58 | $5,218.08 | — | 2025-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | Aetna | Managed Medicare | $1,106.23 | $5,218.08 | — | 2024-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $1,106.23 | $5,218.08 | — | 2025-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $1,106.23 | $5,218.08 | — | 2025-12-31 | MRF ↗ |
| Hackensack University Medical Center OutpatientFacility | OPTUM HEALTH | MANAGED MEDICAID | $1,147.98 | $5,218.08 | — | 2025-12-31 | MRF ↗ |
| Hackensack University Medical Center OutpatientFacility | OPTUM HEALTH | MANAGED MEDICAID | $1,147.98 | $5,218.08 | — | 2025-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,205.38 | $5,218.08 | — | 2025-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,205.38 | $5,218.08 | — | 2025-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | Seoul Medical Group | All Products | $1,210.59 | $5,218.08 | — | 2024-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $1,210.59 | $5,218.08 | — | 2025-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $1,210.59 | $5,218.08 | — | 2025-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | Horizon Braven | Managed Medicare | $1,210.59 | $5,218.08 | — | 2024-12-31 | MRF ↗ |
| Hackensack University Medical Center OutpatientFacility | AETNA | MANAGED MEDICAID | $1,309.74 | $5,218.08 | — | 2025-12-31 | MRF ↗ |
| Hackensack University Medical Center OutpatientFacility | AETNA | MANAGED MEDICAID | $1,309.74 | $5,218.08 | — | 2025-12-31 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | CIGNA | ALL PRODUCTS | $1,463.48 | $2,111.80 | $1,055.90 | 2026-07-01 | MRF ↗ |
| Hackensack University Medical Center OutpatientFacility | SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,492.37 | $5,218.08 | — | 2025-12-31 | MRF ↗ |
| Hackensack University Medical Center OutpatientFacility | SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,492.37 | $5,218.08 | — | 2025-12-31 | MRF ↗ |
| Hackensack University Medical Center OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $1,544.55 | $5,218.08 | — | 2025-12-31 | MRF ↗ |
| Hackensack University Medical Center OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $1,544.55 | $5,218.08 | — | 2025-12-31 | MRF ↗ |
| MEDINA HOSPITAL OutpatientFacility | ANTHEM | HPN | $2,280.46 | $13,680.00 | $8,892.00 | 2025-06-28 | MRF ↗ |
| MEDINA HOSPITAL OutpatientFacility | ANTHEM | PPO/HMO | $2,533.54 | $13,680.00 | $8,892.00 | 2025-06-28 | MRF ↗ |
| HILLCREST HOSPITAL OutpatientFacility | ANTHEM | HPN | $2,540.38 | $13,680.00 | $8,892.00 | 2025-06-28 | MRF ↗ |
| Hackensack University Medical Center OutpatientFacility | HORIZON | MANAGED MEDICAID | $2,582.95 | $5,218.08 | — | 2025-12-31 | MRF ↗ |
| Hackensack University Medical Center OutpatientFacility | HORIZON | MANAGED MEDICAID | $2,582.95 | $5,218.08 | — | 2025-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | Beacon | All Products | $2,609.04 | $5,218.08 | — | 2024-12-31 | MRF ↗ |
| HILLCREST HOSPITAL OutpatientFacility | ANTHEM | PPO/HMO | $2,822.18 | $13,680.00 | $8,892.00 | 2025-06-28 | MRF ↗ |
| CLEVELAND CLINIC MARTIN NORTH HOSPITAL OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $2,845.44 | $13,680.00 | $8,892.00 | 2025-06-28 | MRF ↗ |
| MARYMOUNT HOSPITAL OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $2,982.24 | $13,680.00 | $8,892.00 | 2025-06-28 | MRF ↗ |
| HILLCREST HOSPITAL OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $2,982.24 | $13,680.00 | $8,892.00 | 2025-06-28 | MRF ↗ |
| EUCLID HOSPITAL OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $2,982.24 | $13,680.00 | $8,892.00 | 2025-06-28 | MRF ↗ |
| SOUTH POINTE HOSPITAL OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $2,982.24 | $13,680.00 | $8,892.00 | 2025-06-28 | MRF ↗ |
| MEDINA HOSPITAL OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $2,982.24 | $13,680.00 | $8,892.00 | 2025-06-28 | MRF ↗ |
| HILLCREST HOSPITAL OutpatientFacility | MMO | ALL PRODUCTS | $3,023.28 | $13,680.00 | $8,892.00 | 2025-06-28 | MRF ↗ |
| LODI COMMUNITY HOSPITAL OutpatientFacility | MMO | ALL PRODUCTS | $3,023.28 | $13,680.00 | $8,892.00 | 2025-06-28 | MRF ↗ |
| MARYMOUNT HOSPITAL OutpatientFacility | MMO | ALL PRODUCTS | $3,036.96 | $13,680.00 | $8,892.00 | 2025-06-28 | MRF ↗ |
| SOUTH POINTE HOSPITAL OutpatientFacility | MMO | ALL PRODUCTS | $3,036.96 | $13,680.00 | $8,892.00 | 2025-06-28 | MRF ↗ |
| EUCLID HOSPITAL OutpatientFacility | MMO | ALL PRODUCTS | $3,036.96 | $13,680.00 | $8,892.00 | 2025-06-28 | MRF ↗ |
| MEDINA HOSPITAL OutpatientFacility | MMO | ALL PRODUCTS | $3,036.96 | $13,680.00 | $8,892.00 | 2025-06-28 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | MANAGED MEDICAID | $3,073.45 | $5,218.08 | — | 2025-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | United | Managed Medicaid | $3,073.45 | $5,218.08 | — | 2024-12-31 | MRF ↗ |
| SOUTHERN OCEAN MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | MANAGED MEDICAID | $3,073.45 | $5,218.08 | — | 2025-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | MANAGED MEDICAID | $3,073.45 | $5,218.08 | — | 2025-12-31 | MRF ↗ |
| SOUTHERN OCEAN MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | MANAGED MEDICAID | $3,073.45 | $5,218.08 | — | 2025-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | Oxford | Value Based/Exchange - All Payor | $3,183.03 | $5,218.08 | — | 2024-12-31 | MRF ↗ |
| MARYMOUNT HOSPITAL OutpatientFacility | UNITED | ALL PRODUCTS | $3,214.80 | $13,680.00 | $8,892.00 | 2025-06-28 | 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.