421039 — Inj Shuntogram
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). INJ SHUNTOGRAM (CDM 421039) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/421039?code_type=CDM
MLA (9th ed.)
“INJ SHUNTOGRAM (CDM 421039) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/421039?code_type=CDM. Accessed .
Chicago (notes-bibliography)
“INJ SHUNTOGRAM (CDM 421039) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/421039?code_type=CDM.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $1,530–$232,628 (25th–75th percentile) across 3 hospitals · 23 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CDM 421039 — 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 |
|---|---|---|---|---|---|---|---|
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | BCBS | MCRPPO | $351.28 | $5,091.00 | $5,091.00 | 2024-10-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | BCBS | MCRHMO | $351.28 | $5,091.00 | $5,091.00 | 2024-10-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | Aetna | MCR | $381.16 | $5,524.00 | $5,524.00 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | BCBS | MCRHMO | $381.16 | $5,524.00 | $5,524.00 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | BCBS | MCRPPO | $381.16 | $5,524.00 | $5,524.00 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | Aetna | MCR | $412.37 | $5,091.00 | $5,091.00 | 2024-10-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | Optimum Healthcare | MGMCR | $427.64 | $5,091.00 | $5,091.00 | 2024-10-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | Optimum Healthcare | MGMCR | $464.02 | $5,524.00 | $5,524.00 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | United | OptionsPPO | $707.07 | $5,524.00 | $5,524.00 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | United | OptionsPPO | $717.83 | $5,091.00 | $5,091.00 | 2024-10-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | Simply Healthcare | MGMCR | $814.56 | $5,091.00 | $5,091.00 | 2024-10-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | Simply Healthcare | MGMCR | $850.70 | $5,524.00 | $5,524.00 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | Positive Healthcare | MCR | $1,120.02 | $5,091.00 | $5,091.00 | 2024-10-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | Positive Healthcare | MCR | $1,215.28 | $5,524.00 | $5,524.00 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | Cigna | NBN | $1,308.39 | $5,091.00 | $5,091.00 | 2024-10-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | Cigna | NBN | $1,320.24 | $5,524.00 | $5,524.00 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | Molina Healthcare | HIX | $1,374.57 | $5,091.00 | $5,091.00 | 2024-10-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | Centurion | PRISN | $1,466.21 | $5,091.00 | $5,091.00 | 2024-10-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | Molina Healthcare | HIX | $1,491.48 | $5,524.00 | $5,524.00 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | Corizon | COMM | $1,527.30 | $5,091.00 | $5,091.00 | 2024-10-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | Centurion | PRISN | $1,529.60 | $5,524.00 | $5,524.00 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | Cigna | PPO | $1,563.29 | $5,524.00 | $5,524.00 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | Cigna | OAP | $1,563.29 | $5,524.00 | $5,524.00 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | Aetna | ASA | $1,657.20 | $5,524.00 | $5,524.00 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | Corizon | COMM | $1,657.20 | $5,524.00 | $5,524.00 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | United | GlobalBenefitPlanAppendix | $2,485.80 | $5,524.00 | $5,524.00 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | Cigna | PPO | $2,509.86 | $5,091.00 | $5,091.00 | 2024-10-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | Beacon Health Options | COMM | $2,545.50 | $5,091.00 | $5,091.00 | 2024-10-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | Plotkin Health | WORKERSCOMP | $2,545.50 | $5,091.00 | $5,091.00 | 2024-10-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | Plotkin Health | COMM | $2,762.00 | $5,524.00 | $5,524.00 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | MultiPlan | PRIMARYNETWORK | $3,970.98 | $5,091.00 | $5,091.00 | 2024-10-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | Evernorth | COMM | $4,072.80 | $5,091.00 | $5,091.00 | 2024-10-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | Evolutions Healthcare | MANAGEDCAREPPO | $4,072.80 | $5,091.00 | $5,091.00 | 2024-10-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | MultiPlan | PRIMARYNETWORK | $4,308.72 | $5,524.00 | $5,524.00 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | Evolutions Healthcare | TRADITIONALPPO | $4,327.35 | $5,091.00 | $5,091.00 | 2024-10-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | MultiPlan | COMPLEMENTARYNETWORK | $4,327.35 | $5,091.00 | $5,091.00 | 2024-10-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | PPO Next | PPO | $4,327.35 | $5,091.00 | $5,091.00 | 2024-10-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | PPO Next | COMM | $4,327.35 | $5,091.00 | $5,091.00 | 2024-10-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | Evolutions Healthcare | MANAGEDCAREPPO | $4,419.20 | $5,524.00 | $5,524.00 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | Evernorth | COMM | $4,419.20 | $5,524.00 | $5,524.00 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | NovaNet | COMM | $4,581.90 | $5,091.00 | $5,091.00 | 2024-10-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | PPO Next | COMM | $4,695.40 | $5,524.00 | $5,524.00 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | Evolutions Healthcare | TRADITIONALPPO | $4,695.40 | $5,524.00 | $5,524.00 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | MultiPlan | COMPLEMENTARYNETWORK | $4,695.40 | $5,524.00 | $5,524.00 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | PPO Next | PPO | $4,695.40 | $5,524.00 | $5,524.00 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | NovaNet | COMM | $4,971.60 | $5,524.00 | $5,524.00 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | United Behavioral Health | VACCN | $5,091.00 | $5,091.00 | $5,091.00 | 2024-10-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | Beacon Health Options | MCR | $5,091.00 | $5,091.00 | $5,091.00 | 2024-10-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | United Behavioral Health | VACCN | $5,524.00 | $5,524.00 | $5,524.00 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | American Health Plan | MCR | $15,000.00 | $5,524.00 | $5,524.00 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA MEMORIAL HOSPITAL Outpatient | American Health Plan | MCR | $15,000.00 | $5,091.00 | $5,091.00 | 2024-10-01 | MRF ↗ |
| LOS ROBLES HOSPITAL & MEDICAL CENTER Outpatient | Aetna | MCR | $53,750.00 | $537,500.00 | $537,500.00 | 2024-10-01 | MRF ↗ |
| Thousand Oaks Surgical Hospital Outpatient | Aetna | MCR | $57,781.30 | $577,813.00 | $577,813.00 | 2026-03-01 | MRF ↗ |
| Thousand Oaks Surgical Hospital Outpatient | Cigna | HMO | $149,075.75 | $577,813.00 | $577,813.00 | 2026-03-01 | MRF ↗ |
| Thousand Oaks Surgical Hospital Outpatient | Cigna | PPO | $149,075.75 | $577,813.00 | $577,813.00 | 2026-03-01 | MRF ↗ |
| LOS ROBLES HOSPITAL & MEDICAL CENTER Outpatient | Blue Shield | EPN | $155,445.00 | $537,500.00 | $537,500.00 | 2024-10-01 | MRF ↗ |
| Thousand Oaks Surgical Hospital Outpatient | United | OptionsPPO | $162,365.45 | $577,813.00 | $577,813.00 | 2026-03-01 | MRF ↗ |
| Thousand Oaks Surgical Hospital Outpatient | Blue Shield | EPN | $162,827.70 | $577,813.00 | $577,813.00 | 2026-03-01 | MRF ↗ |
| LOS ROBLES HOSPITAL & MEDICAL CENTER Outpatient | United | OptionsPPO | $166,087.50 | $537,500.00 | $537,500.00 | 2024-10-01 | MRF ↗ |
| LOS ROBLES HOSPITAL & MEDICAL CENTER Outpatient | Blue Shield | COMM | $222,041.25 | $537,500.00 | $537,500.00 | 2024-10-01 | MRF ↗ |
| Thousand Oaks Surgical Hospital Outpatient | Blue Shield | COMM | $232,627.51 | $577,813.00 | $577,813.00 | 2026-03-01 | MRF ↗ |
| LOS ROBLES HOSPITAL & MEDICAL CENTER Outpatient | ChoiceCare Network | COMMPPO | $376,250.00 | $537,500.00 | $537,500.00 | 2024-10-01 | MRF ↗ |
| Thousand Oaks Surgical Hospital Outpatient | ChoiceCare Network | COMMPPO | $404,469.10 | $577,813.00 | $577,813.00 | 2026-03-01 | MRF ↗ |
| LOS ROBLES HOSPITAL & MEDICAL CENTER Outpatient | Multiplan | PRIMARY | $430,000.00 | $537,500.00 | $537,500.00 | 2024-10-01 | MRF ↗ |
| LOS ROBLES HOSPITAL & MEDICAL CENTER Outpatient | PPO Next | PPO | $430,000.00 | $537,500.00 | $537,500.00 | 2024-10-01 | MRF ↗ |
| LOS ROBLES HOSPITAL & MEDICAL CENTER Outpatient | PPO Next | WC | $430,000.00 | $537,500.00 | $537,500.00 | 2024-10-01 | MRF ↗ |
| LOS ROBLES HOSPITAL & MEDICAL CENTER Outpatient | First Health | WCOMP | $430,000.00 | $537,500.00 | $537,500.00 | 2024-10-01 | MRF ↗ |
| Thousand Oaks Surgical Hospital Outpatient | PPO Next | WC | $462,250.40 | $577,813.00 | $577,813.00 | 2026-03-01 | MRF ↗ |
| Thousand Oaks Surgical Hospital Outpatient | First Health | WCOMP | $462,250.40 | $577,813.00 | $577,813.00 | 2026-03-01 | MRF ↗ |
| Thousand Oaks Surgical Hospital Outpatient | Multiplan | PRIMARY | $462,250.40 | $577,813.00 | $577,813.00 | 2026-03-01 | MRF ↗ |
| Thousand Oaks Surgical Hospital Outpatient | PPO Next | PPO | $462,250.40 | $577,813.00 | $577,813.00 | 2026-03-01 | MRF ↗ |
| LOS ROBLES HOSPITAL & MEDICAL CENTER Outpatient | Interplan Corporation | COMM | $483,750.00 | $537,500.00 | $537,500.00 | 2024-10-01 | MRF ↗ |
| LOS ROBLES HOSPITAL & MEDICAL CENTER Outpatient | Ventura County Foundation | COMM | $483,750.00 | $537,500.00 | $537,500.00 | 2024-10-01 | MRF ↗ |
| LOS ROBLES HOSPITAL & MEDICAL CENTER Outpatient | Interplan Corporation | WC | $483,750.00 | $537,500.00 | $537,500.00 | 2024-10-01 | MRF ↗ |
| LOS ROBLES HOSPITAL & MEDICAL CENTER Outpatient | Multiplan | COMPLEMENTARY | $510,625.00 | $537,500.00 | $537,500.00 | 2024-10-01 | MRF ↗ |
| Thousand Oaks Surgical Hospital Outpatient | Ventura County Foundation | COMM | $520,031.70 | $577,813.00 | $577,813.00 | 2026-03-01 | MRF ↗ |
| Thousand Oaks Surgical Hospital Outpatient | Interplan Corporation | COMM | $520,031.70 | $577,813.00 | $577,813.00 | 2026-03-01 | MRF ↗ |
| Thousand Oaks Surgical Hospital Outpatient | Interplan Corporation | WC | $520,031.70 | $577,813.00 | $577,813.00 | 2026-03-01 | MRF ↗ |
| LOS ROBLES HOSPITAL & MEDICAL CENTER Outpatient | Aetna Senior Health Plan | MCR | $537,500.00 | $537,500.00 | $537,500.00 | 2024-10-01 | MRF ↗ |
| Thousand Oaks Surgical Hospital Outpatient | Multiplan | COMPLEMENTARY | $548,922.35 | $577,813.00 | $577,813.00 | 2026-03-01 | MRF ↗ |
| Thousand Oaks Surgical Hospital Outpatient | Aetna Senior Health Plan | MCR | $577,813.00 | $577,813.00 | $577,813.00 | 2026-03-01 | MRF ↗ |