420422 — Retr Surg 18m Sm Frag St
Cite this view
HANK Price Transparency. (n.d.). RETR SURG 18M SM FRAG ST (CDM 420422) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/420422?code_type=CDM
“RETR SURG 18M SM FRAG ST (CDM 420422) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/420422?code_type=CDM. Accessed .
“RETR SURG 18M SM FRAG ST (CDM 420422) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/420422?code_type=CDM.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $415–$1,484 (25th–75th percentile) across 2 hospitals · 28 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CDM 420422 — 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 |
|---|---|---|---|---|---|---|---|
| TRISTAR SUMMIT MEDICAL CENTER Outpatient | Aetna | MGMCRSNP | $265.88 | $1,772.50 | $1,772.50 | 2024-10-01 | MRF ↗ |
| TRISTAR SUMMIT MEDICAL CENTER Outpatient | Aetna | MGMCRHMO | $265.88 | $1,772.50 | $1,772.50 | 2024-10-01 | MRF ↗ |
| TRISTAR SUMMIT MEDICAL CENTER Outpatient | Aetna | MGMCRPPO | $265.88 | $1,772.50 | $1,772.50 | 2024-10-01 | MRF ↗ |
| TRISTAR SUMMIT MEDICAL CENTER Outpatient | Bright Health | HIX | $301.32 | $1,772.50 | $1,772.50 | 2024-10-01 | MRF ↗ |
| TRISTAR SUMMIT MEDICAL CENTER Outpatient | Kentucky Labor Cabinet | WORKERSCOMP | $326.32 | $1,772.50 | $1,772.50 | 2024-10-01 | MRF ↗ |
| TRISTAR SUMMIT MEDICAL CENTER Outpatient | Oscar | HIX | $333.23 | $1,772.50 | $1,772.50 | 2024-10-01 | MRF ↗ |
| TRISTAR SUMMIT MEDICAL CENTER Outpatient | NHC Advantage, Inc. | MCRHMO | $336.77 | $1,772.50 | $1,772.50 | 2024-10-01 | MRF ↗ |
| TRISTAR SUMMIT MEDICAL CENTER Outpatient | Pruitt Health (AllyAlign) | MCR | $336.77 | $1,772.50 | $1,772.50 | 2024-10-01 | MRF ↗ |
| TRISTAR SUMMIT MEDICAL CENTER Outpatient | Apex Health | MCR | $336.77 | $1,772.50 | $1,772.50 | 2024-10-01 | MRF ↗ |
| TRISTAR SUMMIT MEDICAL CENTER Outpatient | Ambetter | CORE | $409.45 | $1,772.50 | $1,772.50 | 2024-10-01 | MRF ↗ |
| TRISTAR SUMMIT MEDICAL CENTER Outpatient | Ambetter | Select | $411.22 | $1,772.50 | $1,772.50 | 2024-10-01 | MRF ↗ |
| TRISTAR SUMMIT MEDICAL CENTER Outpatient | BCBS | NetworkP | $425.40 | $1,772.50 | $1,772.50 | 2024-10-01 | MRF ↗ |
| TRISTAR SUMMIT MEDICAL CENTER Outpatient | Bright Health | SmallGroup | $425.40 | $1,772.50 | $1,772.50 | 2024-10-01 | MRF ↗ |
| TRISTAR SUMMIT MEDICAL CENTER Outpatient | Humana | TRICARE | $443.13 | $1,772.50 | $1,772.50 | 2024-10-01 | MRF ↗ |
| TRISTAR SUMMIT MEDICAL CENTER Outpatient | United | OptionsPPO | $494.53 | $1,772.50 | $1,772.50 | 2024-10-01 | MRF ↗ |
| TRISTAR SUMMIT MEDICAL CENTER Outpatient | Aetna | NewBusiness | $514.02 | $1,772.50 | $1,772.50 | 2024-10-01 | MRF ↗ |
| TRISTAR SUMMIT MEDICAL CENTER Outpatient | Cigna | OAP | $547.70 | $1,772.50 | $1,772.50 | 2024-10-01 | MRF ↗ |
| TRISTAR SUMMIT MEDICAL CENTER Outpatient | Aetna | COMM | $602.65 | $1,772.50 | $1,772.50 | 2024-10-01 | MRF ↗ |
| TRISTAR SUMMIT MEDICAL CENTER Outpatient | Cigna | PPO | $623.92 | $1,772.50 | $1,772.50 | 2024-10-01 | MRF ↗ |
| TRISTAR SUMMIT MEDICAL CENTER Outpatient | Centurion | PRISON | $730.27 | $1,772.50 | $1,772.50 | 2024-10-01 | MRF ↗ |
| TRISTAR SUMMIT MEDICAL CENTER Outpatient | United | GlobalBenefitPlan | $797.63 | $1,772.50 | $1,772.50 | 2024-10-01 | MRF ↗ |
| TRISTAR SUMMIT MEDICAL CENTER Outpatient | Plumbers and Pipefitters Local 572 | COMMPPO | $886.25 | $1,772.50 | $1,772.50 | 2024-10-01 | MRF ↗ |
| TRISTAR SUMMIT MEDICAL CENTER Outpatient | Signature Advantage | MCR | $886.25 | $1,772.50 | $1,772.50 | 2024-10-01 | MRF ↗ |
| TRISTAR SUMMIT MEDICAL CENTER Outpatient | BGFH SingleSource | DIRECTNETWORK | $886.25 | $1,772.50 | $1,772.50 | 2024-10-01 | MRF ↗ |
| TRISTAR SUMMIT MEDICAL CENTER Outpatient | Humana BH | COMM | $1,152.13 | $1,772.50 | $1,772.50 | 2024-10-01 | MRF ↗ |
| TRISTAR SUMMIT MEDICAL CENTER Outpatient | Multiplan | COMM | $1,152.13 | $1,772.50 | $1,772.50 | 2024-10-01 | MRF ↗ |
| TRISTAR SUMMIT MEDICAL CENTER Outpatient | Employers Health Network | COMM | $1,240.75 | $1,772.50 | $1,772.50 | 2024-10-01 | MRF ↗ |
| TRISTAR SUMMIT MEDICAL CENTER Outpatient | Odom's TN Pride Sausage | WORKERSCOMP | $1,329.38 | $1,772.50 | $1,772.50 | 2024-10-01 | MRF ↗ |
| TRISTAR SUMMIT MEDICAL CENTER Outpatient | ComPsych | COMM | $1,418.00 | $1,772.50 | $1,772.50 | 2024-10-01 | MRF ↗ |
| TRISTAR SUMMIT MEDICAL CENTER Outpatient | Alive Hospice, Inc. | COMM | $1,418.00 | $1,772.50 | $1,772.50 | 2024-10-01 | MRF ↗ |
| TRISTAR SUMMIT MEDICAL CENTER Outpatient | Cigna Evernorth Behavioral Health | COMM | $1,418.00 | $1,772.50 | $1,772.50 | 2024-10-01 | MRF ↗ |
| TRISTAR SUMMIT MEDICAL CENTER Outpatient | BGFH SingleSource | LEASEDNETWORK | $1,506.63 | $1,772.50 | $1,772.50 | 2024-10-01 | MRF ↗ |
| TRISTAR SUMMIT MEDICAL CENTER Outpatient | Prime Health | COMMPPO | $1,559.80 | $1,772.50 | $1,772.50 | 2024-10-01 | MRF ↗ |
| TRISTAR SUMMIT MEDICAL CENTER Outpatient | Beech Street | COMM | $1,559.80 | $1,772.50 | $1,772.50 | 2024-10-01 | MRF ↗ |
| TRISTAR SUMMIT MEDICAL CENTER Outpatient | Southern Benefit Admin | LOGOV | $1,595.25 | $1,772.50 | $1,772.50 | 2024-10-01 | MRF ↗ |
| PRATT REGIONAL MEDICAL CENTER Outpatient | Christian Health Aid | Commercial | $14,495.00 | $19,326.00 | $13,528.00 | 2025-10-24 | MRF ↗ |
| TRISTAR SUMMIT MEDICAL CENTER Outpatient | Farm Bureau | MCR | $15,000.00 | $1,772.50 | $1,772.50 | 2024-10-01 | MRF ↗ |
| PRATT REGIONAL MEDICAL CENTER Outpatient | United Healthcare | Commercial | $16,079.00 | $19,326.00 | $13,528.00 | 2025-10-24 | MRF ↗ |
| PRATT REGIONAL MEDICAL CENTER Outpatient | Health Partners of Kansas | Commercial | $16,427.00 | $19,326.00 | $13,528.00 | 2025-10-24 | MRF ↗ |
| PRATT REGIONAL MEDICAL CENTER Outpatient | Aetna | Commercial | $17,393.00 | $19,326.00 | $13,528.00 | 2025-10-24 | MRF ↗ |
| PRATT REGIONAL MEDICAL CENTER Outpatient | ChoiceCare | Commercial | $19,326.00 | $19,326.00 | $13,528.00 | 2025-10-24 | MRF ↗ |
| PRATT REGIONAL MEDICAL CENTER Outpatient | United Healthcare | Medicare Advantage | $19,713.00 | $19,326.00 | $13,528.00 | 2025-10-24 | MRF ↗ |