42211010243 — Indomethacin 50 Mg Supp 30 Each Box
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). INDOMETHACIN 50 MG SUPP 30 EACH BOX (NDC 42211010243) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/42211010243?code_type=NDC
MLA (9th ed.)
“INDOMETHACIN 50 MG SUPP 30 EACH BOX (NDC 42211010243) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/42211010243?code_type=NDC. Accessed .
Chicago (notes-bibliography)
“INDOMETHACIN 50 MG SUPP 30 EACH BOX (NDC 42211010243) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/42211010243?code_type=NDC.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $153–$448 (25th–75th percentile) across 22 hospitals · 150 payers.
“Negotiated” is the hospital’s negotiated facility rate for this NDC 42211010243 — 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 |
|---|---|---|---|---|---|---|---|
| NORTHEAST ALABAMA REGIONAL MEDICAL CENTER Both | Cigna | Commercial | $4.61 | $14.07 | $9.15 | 2026-07-15 | MRF ↗ |
| NORTHEAST ALABAMA REGIONAL MEDICAL CENTER Both | Viva Health | Commercial | $5.17 | $14.07 | $9.15 | 2026-07-15 | MRF ↗ |
| NORTHEAST ALABAMA REGIONAL MEDICAL CENTER Both | Aetna | Commercial | $6.75 | $14.07 | $9.15 | 2026-07-15 | MRF ↗ |
| ERLANGER MURPHY MEDICAL CENTER BothFacility | Peach State | All Products | $29.12 | $144.00 | $100.80 | 2026-01-25 | MRF ↗ |
| ERLANGER MURPHY MEDICAL CENTER OutpatientFacility | UNITEDHEALTHCARE | MEDICARE ADVANTAGE | $36.00 | $144.00 | $100.80 | 2026-01-25 | MRF ↗ |
| ERLANGER MURPHY MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $36.00 | $144.00 | $100.80 | 2026-01-25 | MRF ↗ |
| ERLANGER MURPHY MEDICAL CENTER OutpatientFacility | BCBSNC | MEDICARE ADVANTAGE | $37.44 | $144.00 | $100.80 | 2026-01-25 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | AETNA | MEDICARE | $46.10 | $408.00 | $61.20 | 2025-12-23 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | AETNA | MEDICARE | $46.10 | $408.00 | $61.20 | 2025-12-23 | MRF ↗ |
| HOLZER MEDICAL CENTER Both | Ohiohealth | Ohiohealthy | $46.28 | $231.00 | $115.70 | 2026-07-15 | MRF ↗ |
| HOLZER MEDICAL CENTER Both | Ohiohealth | Ohiohealthypremier | $46.28 | $231.00 | $115.70 | 2026-07-15 | MRF ↗ |
| ERLANGER MURPHY MEDICAL CENTER BothFacility | BCBSNC | ALL PRODUCTS | $49.55 | $144.00 | $100.80 | 2026-01-25 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | FL BLUE | MY BLUE NETWORK | $61.20 | $408.00 | $61.20 | 2025-12-23 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | PENSACOLA | CHRISTIAN COLL | $61.20 | $408.00 | $61.20 | 2025-12-23 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | PENSACOLA | CHRISTIAN COLL | $61.20 | $408.00 | $61.20 | 2025-12-23 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE | $71.91 | $479.40 | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South BothFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE-Ped | $71.91 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST BothFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE-Ped | $71.91 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE | $71.91 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | BLUE CROSS | BlueMedicare HMO | $71.91 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE | $71.91 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | BLUE CROSS | Medicare PPO | $71.91 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE BothFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE-Ped | $71.91 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST BothFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE-Ped | $71.91 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE | $71.91 | $479.40 | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE | $71.91 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR BothFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE-Ped | $71.91 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | UNITED | EXCHANGE | $76.22 | $479.40 | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | UNITED | EXCHANGE | $76.22 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | UNITED | EXCHANGE | $76.22 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | UNITED | EXCHANGE | $76.22 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | UNITED | EXCHANGE | $76.22 | $479.40 | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | MOLINA | EXCHANGE | $76.70 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | MOLINA | EXCHANGE | $76.70 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | MOLINA | EXCHANGE | $76.70 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | MOLINA | EXCHANGE | $76.70 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | MOLINA | EXCHANGE | $76.70 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | BLUE CROSS | MyBlue | $77.23 | $479.40 | — | 2025-07-30 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | FL BLUE | BLUE SELECT | $77.52 | $408.00 | $61.20 | 2025-12-23 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | FL BLUE | SIMPLY BLUE NETWORK | $77.52 | $408.00 | $61.20 | 2025-12-23 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | FL BLUE | HEALTH OPTIONS HMO | $77.52 | $408.00 | $61.20 | 2025-12-23 | MRF ↗ |
| HOLZER MEDICAL CENTER Both | Ohiohealth | Ohiouniv | $80.99 | $231.00 | $115.70 | 2026-07-15 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | AVMED | Medicare | $81.02 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | AVMED | Medicare | $81.02 | $479.40 | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | AVMED | Medicare | $81.02 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | AVMED | Medicare | $81.02 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | AVMED | Medicare | $81.02 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | CIGNA | EXCHANGE | $81.50 | $479.40 | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | CIGNA | EXCHANGE | $81.50 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | CIGNA | EXCHANGE | $81.50 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | CIGNA | EXCHANGE | $81.50 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | CIGNA | EXCHANGE | $81.50 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | BLUE CROSS | BLUE SELECT | $81.50 | $479.40 | — | 2025-07-30 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | FL BLUE | MY BLUE NETWORK | $85.68 | $408.00 | $61.20 | 2025-12-23 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE BothFacility | Aetna Better Health | Healthy Kids | $86.29 | $479.40 | — | 2025-07-30 | MRF ↗ |
| ERLANGER MURPHY MEDICAL CENTER OutpatientFacility | HUMANA | ALL PRODUCTS | $86.40 | $144.00 | $100.80 | 2026-01-25 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | BC FL | MEDICARE HMO | $89.76 | $408.00 | $61.20 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | UHC | MCARE ADV PLN | $89.76 | $408.00 | $61.20 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | WELLCARE | MCARE HMO DUAL PLAN | $89.76 | $408.00 | $61.20 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | AETNA | MEDICARE | $89.76 | $408.00 | $61.20 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | UHC | MCARE ADV DUAL PLAN | $89.76 | $408.00 | $61.20 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | HUMANA | MCARE CHOICE PPO | $89.76 | $408.00 | $61.20 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | WELLCARE | MCARE HMO | $89.76 | $408.00 | $61.20 | 2025-12-23 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | BLUE CROSS | Simply Blue | $90.08 | $479.40 | — | 2025-07-30 | MRF ↗ |
| BAPTIST MEDICAL CENTER EAST OutpatientFacility | Viva Health | All Products | $91.80 | $204.00 | $122.40 | 2025-12-30 | MRF ↗ |
| PRATTVILLE BAPTIST HOSPITAL OutpatientFacility | Viva Health | All Products | $91.80 | $204.00 | $122.40 | 2025-12-30 | MRF ↗ |
| BAPTIST MEDICAL CENTER EAST OutpatientFacility | Viva Health | All Products | $91.80 | $204.00 | $122.40 | 2025-12-30 | MRF ↗ |
| PRATTVILLE BAPTIST HOSPITAL OutpatientFacility | Viva Health | All Products | $91.80 | $204.00 | $122.40 | 2025-12-30 | MRF ↗ |
| BAPTIST MEDICAL CENTER SOUTH OutpatientFacility | Viva Health | All Products | $91.80 | $204.00 | $122.40 | 2025-12-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | BLUE CROSS | HMO | $93.20 | $479.40 | — | 2025-07-30 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | FL BLUE | NWB - BLUE OPTIONS | $93.84 | $408.00 | $61.20 | 2025-12-23 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | Solis Health Plan | Medicare | $95.88 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | BLUE CROSS | Medicare PPO | $95.88 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | BLUE CROSS | Medicare PPO | $95.88 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | BLUE CROSS | BlueMedicare HMO | $95.88 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | BLUE CROSS | BlueMedicare HMO | $95.88 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | Solis Health Plan | Medicare | $95.88 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | Solis Health Plan | Medicare | $95.88 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | Solis Health Plan | Medicare | $95.88 | $479.40 | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | Solis Health Plan | Medicare | $95.88 | $479.40 | — | 2025-07-30 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | UHC OF FL | NEIGHBORHOOD PLAN | $96.70 | $408.00 | $61.20 | 2025-12-23 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | FL BLUE | SIMPLY BLUE NETWORK | $97.92 | $408.00 | $61.20 | 2025-12-23 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | FL BLUE | BLUE SELECT | $97.92 | $408.00 | $61.20 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | FL BLUE | MY BLUE NETWORK | $97.92 | $408.00 | $61.20 | 2025-12-23 | MRF ↗ |
| Memorial Regional Hospital South BothFacility | Aetna Better Health | Healthy Kids-Ped | $100.67 | $479.40 | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | Aetna Better Health | Healthy Kids | $100.67 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR BothFacility | Aetna Better Health | Healthy Kids-Ped | $100.67 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | Aetna Better Health | Healthy Kids | $100.67 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | Aetna Better Health | Healthy Kids | $100.67 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST BothFacility | Aetna Better Health | Healthy Kids-Ped | $100.67 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST BothFacility | Aetna Better Health | Healthy Kids-Ped | $100.67 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | Aetna Better Health | Healthy Kids | $100.67 | $479.40 | — | 2025-07-30 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | UHC OF FL | POS/HMO | $101.18 | $408.00 | $61.20 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | UHC COMMUNITY | MCAID HMO | $102.00 | $408.00 | $61.20 | 2025-12-23 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | UHC COMMUNITY | MCAID HMO | $102.00 | $408.00 | $61.20 | 2025-12-23 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | UHC COMMUNITY | MCAID HMO | $102.00 | $408.00 | $61.20 | 2025-12-23 | MRF ↗ |
| ERLANGER MURPHY MEDICAL CENTER InpatientFacility | BCBSNC | ALL PRODUCTS | $102.34 | $144.00 | $100.80 | 2026-01-25 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | BC FL | MEDICARE HMO | $106.08 | $408.00 | $61.20 | 2025-12-23 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | UHC OF FL | POS/HMO | $108.12 | $408.00 | $61.20 | 2025-12-23 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | UHC OF FL | POS/HMO | $108.12 | $408.00 | $61.20 | 2025-12-23 | MRF ↗ |
| ERLANGER MURPHY MEDICAL CENTER BothFacility | CIGNA HEALTHCARE | ALL PRODUCTS | $109.87 | $144.00 | $100.80 | 2026-01-25 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | FL BLUE | PPC-BLUE CHOICE | $110.16 | $408.00 | $61.20 | 2025-12-23 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | BLUE CROSS | BlueMedicare HMO | $110.26 | $479.40 | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | BLUE CROSS | Medicare PPO | $110.26 | $479.40 | — | 2025-07-30 | MRF ↗ |
| ERLANGER MURPHY MEDICAL CENTER BothFacility | UNITEDHEALTHCARE | ALL PRODUCTS | $110.88 | $144.00 | $100.80 | 2026-01-25 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | BLUE CROSS | NetworkBlue/BlueOptions | $113.57 | $479.40 | — | 2025-07-30 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | FL BLUE | HEALTH OPTIONS HMO | $114.24 | $408.00 | $61.20 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | FL BLUE | BLUE SELECT | $114.24 | $408.00 | $61.20 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | FL BLUE | SIMPLY BLUE NETWORK | $114.24 | $408.00 | $61.20 | 2025-12-23 | MRF ↗ |
| HOLZER MEDICAL CENTER Both | Anthem Exchange | Hmo | $116.63 | $231.00 | $115.70 | 2026-07-15 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | FL BLUE | INDEMNITY | $118.32 | $408.00 | $61.20 | 2025-12-23 | MRF ↗ |
| MEMORIAL HOSPITAL WEST InpatientFacility | Aetna Better Health | Healthy Kids-Ped | $119.85 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR InpatientFacility | Aetna Better Health | Healthy Kids-Ped | $119.85 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST InpatientFacility | Aetna Better Health | Healthy Kids-Ped | $119.85 | $479.40 | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South InpatientFacility | Aetna Better Health | Healthy Kids-Ped | $119.85 | $479.40 | — | 2025-07-30 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | HOSPICE REGENCY | ALL PRODUCTS | $122.40 | $408.00 | $61.20 | 2025-12-23 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | HOSPICE REGENCY | ALL PRODUCTS | $122.40 | $408.00 | $61.20 | 2025-12-23 | MRF ↗ |
| HOLZER MEDICAL CENTER Both | Anthem Exchange | Ppo | $122.87 | $231.00 | $115.70 | 2026-07-15 | MRF ↗ |
| ERLANGER MURPHY MEDICAL CENTER BothFacility | AETNA | ALL PRODUCTS | $123.84 | $144.00 | $100.80 | 2026-01-25 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | BC FL | MEDICARE HMO | $126.48 | $408.00 | $61.20 | 2025-12-23 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | Blue Cross PPC | Blue Choice | $127.38 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | AVMED | EXCHANGE | $128.48 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | AVMED | EXCHANGE | $128.48 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | AVMED | EXCHANGE | $128.48 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | AVMED | EXCHANGE | $128.48 | $479.40 | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | AVMED | EXCHANGE | $128.48 | $479.40 | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | BLUE CROSS | Blue Select-Ped | $128.77 | $479.40 | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | BLUE CROSS | BLUE SELECT | $128.77 | $479.40 | — | 2025-07-30 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | FL BLUE | HEALTH OPTIONS HMO | $130.56 | $408.00 | $61.20 | 2025-12-23 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | AETNA | Qualified Health Plans | $131.55 | $479.40 | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South BothFacility | AETNA | Qualified Health Plans-Ped | $131.55 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST BothFacility | AETNA | Qualified Health Plans-Ped | $131.55 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | AETNA | Qualified Health Plans | $131.55 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST BothFacility | AETNA | Qualified Health Plans-Ped | $131.55 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | AETNA | Qualified Health Plans | $131.55 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | AETNA | Qualified Health Plans | $131.55 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR BothFacility | AETNA | Qualified Health Plans-Ped | $131.55 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE BothFacility | AETNA | Qualified Health Plans-Ped | $131.55 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | AETNA | Qualified Health Plans | $131.55 | $479.40 | — | 2025-07-30 | MRF ↗ |
| HOLZER MEDICAL CENTER Both | Anthem Comm | Preferred Ppo | $132.36 | $231.00 | $115.70 | 2026-07-15 | MRF ↗ |
| HOLZER MEDICAL CENTER Both | Anthem Comm | Blue Access Ppo | $132.36 | $231.00 | $115.70 | 2026-07-15 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | BLUE CROSS | MyBlue | $133.03 | $479.40 | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | BLUE CROSS | Simply Blue-Ped | $133.03 | $479.40 | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | BLUE CROSS | MyBlue-Ped | $133.03 | $479.40 | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | BLUE CROSS | Simply Blue | $133.03 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | BLUE CROSS | MyBlue-Ped | $133.03 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | BLUE CROSS | BLUE SELECT | $133.03 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | BLUE CROSS | Simply Blue-Ped | $133.03 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | BLUE CROSS | MyBlue-Ped | $133.03 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | BLUE CROSS | MyBlue | $133.03 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | BLUE CROSS | MyBlue | $133.03 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | BLUE CROSS | Blue Select-Ped | $133.03 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | BLUE CROSS | Simply Blue | $133.03 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | BLUE CROSS | Simply Blue | $133.03 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | BLUE CROSS | MyBlue-Ped | $133.03 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | BLUE CROSS | MyBlue | $133.03 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | BLUE CROSS | BLUE SELECT | $133.03 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | BLUE CROSS | Simply Blue | $133.03 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | BLUE CROSS | Blue Select-Ped | $133.03 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | BLUE CROSS | Blue Select-Ped | $133.03 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | BLUE CROSS | Simply Blue-Ped | $133.03 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | BLUE CROSS | Simply Blue-Ped | $133.03 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | BLUE CROSS | BLUE SELECT | $133.03 | $479.40 | — | 2025-07-30 | MRF ↗ |
| Wyoming County Community Hospital Inpatient | Excellus Health | Medicaid Managed | — | $4.63 | $3.24 | 2026-07-17 | MRF ↗ |
| Wyoming County Community Hospital Inpatient | Molina Healthcare | Medicaid | — | $4.63 | $3.24 | 2026-07-17 | MRF ↗ |
| Wyoming County Community Hospital Inpatient | Fidelis | Managed Medicaid | — | $4.63 | $3.24 | 2026-07-17 | MRF ↗ |
| Wyoming County Community Hospital Inpatient | Amerigroup | Managed Medicaid | — | $4.63 | $3.24 | 2026-07-17 | MRF ↗ |
| Wyoming County Community Hospital Inpatient | Wellcare | Commercial | — | $4.63 | $3.24 | 2026-07-17 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | AVMED | Select | $134.23 | $479.40 | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | AVMED | ALL PRODUCTS | $134.23 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | AVMED | ALL PRODUCTS | $134.23 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | AVMED | Select | $134.23 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | AVMED | ALL PRODUCTS | $134.23 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | AVMED | ALL PRODUCTS | $134.23 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | AVMED | Select | $134.23 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | AVMED | Select | $134.23 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | AVMED | Select | $134.23 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | AVMED | ALL PRODUCTS | $134.23 | $479.40 | — | 2025-07-30 | MRF ↗ |
| ERLANGER MURPHY MEDICAL CENTER BothFacility | MEDCOST | ALL PRODUCTS | $135.36 | $144.00 | $100.80 | 2026-01-25 | MRF ↗ |
| HOLZER MEDICAL CENTER Both | Anthem Comm | Blue Trad | $135.37 | $231.00 | $115.70 | 2026-07-15 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | BLUE CROSS | HMO | $137.44 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | BLUE CROSS | HMO-Ped | $137.44 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | BLUE CROSS | HMO | $137.44 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | BLUE CROSS | HMO-Ped | $137.44 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | BLUE CROSS | HMO | $137.44 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | BLUE CROSS | HMO | $137.44 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | BLUE CROSS | HMO-Ped | $137.44 | $479.40 | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | BLUE CROSS | HMO-Ped | $137.44 | $479.40 | — | 2025-07-30 | MRF ↗ |
| BAPTIST MEDICAL CENTER EAST BothFacility | First Health | All Products | $142.80 | $204.00 | $122.40 | 2025-12-30 | MRF ↗ |
| PRATTVILLE BAPTIST HOSPITAL BothFacility | First Health | All Products | $142.80 | $204.00 | $122.40 | 2025-12-30 | MRF ↗ |
| BAPTIST MEDICAL CENTER SOUTH BothFacility | First Health | All Products | $142.80 | $204.00 | $122.40 | 2025-12-30 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | FL BLUE | NWB - BLUE OPTIONS | $142.80 | $408.00 | $61.20 | 2025-12-23 | MRF ↗ |
| PRATTVILLE BAPTIST HOSPITAL BothFacility | First Health | All Products | $142.80 | $204.00 | $122.40 | 2025-12-30 | MRF ↗ |
| BAPTIST MEDICAL CENTER EAST BothFacility | First Health | All Products | $142.80 | $204.00 | $122.40 | 2025-12-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | BLUE CROSS | NetworkBlue/BlueOptions | $145.40 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | BLUE CROSS | NetworkBlue/BlueOptions-Ped | $145.40 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | BLUE CROSS | NetworkBlue/BlueOptions-Ped | $145.40 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | BLUE CROSS | NetworkBlue/BlueOptions | $145.40 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | BLUE CROSS | NetworkBlue/BlueOptions-Ped | $145.40 | $479.40 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | BLUE CROSS | NetworkBlue/BlueOptions | $145.40 | $479.40 | — | 2025-07-30 | 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.