43259 — Egd US Exam Duodenum/jejunum
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). EGD US EXAM DUODENUM/JEJUNUM (CPT 43259) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/43259?code_type=CPT
MLA (9th ed.)
“EGD US EXAM DUODENUM/JEJUNUM (CPT 43259) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/43259?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“EGD US EXAM DUODENUM/JEJUNUM (CPT 43259) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/43259?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $1,638–$3,669 (25th–75th percentile) across 2,268 hospitals · 5,183 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 43259 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.
Also priced as a different code
The same procedure is billed under different code systems depending on the setting. These facilities price it under a code you won’t see in the CPT/HCPCS 43259 table above — including hospitals that only publish the bundled version.
2,997 facilities · 986 not in the CPT/HCPCS table
- ABBEVILLE GENERAL HOSPITAL, ABBEVILLE • only here
- ABBOTT NORTHWESTERN HOSPITAL, MINNEAPOLIS • only here
- ABRAHAM LINCOLN MEMORIAL HOSPITAL, LINCOLN • only here
- ACADIAN MEDICAL CENTER, EUNICE • only here
- Acuity Specialty Hospital Of New Jersey, Atlantic City • only here
- Acuity Specialty Hospital Ohio Valley, BELLAIRE • only here
2,956 facilities · 962 not in the CPT/HCPCS table
- ABBEVILLE GENERAL HOSPITAL, ABBEVILLE • only here
- ABBOTT NORTHWESTERN HOSPITAL, MINNEAPOLIS • only here
- ABRAHAM LINCOLN MEMORIAL HOSPITAL, LINCOLN • only here
- ACADIAN MEDICAL CENTER, EUNICE • only here
- Acuity Specialty Hospital Of New Jersey, Atlantic City • only here
- Acuity Specialty Hospital Ohio Valley, BELLAIRE • only here
2,711 facilities · 819 not in the CPT/HCPCS table
- ABBEVILLE GENERAL HOSPITAL, ABBEVILLE • only here
- ABBOTT NORTHWESTERN HOSPITAL, MINNEAPOLIS • only here
- ABRAHAM LINCOLN MEMORIAL HOSPITAL, LINCOLN • only here
- ACADIAN MEDICAL CENTER, EUNICE • only here
- Acuity Specialty Hospital Of New Jersey, Atlantic City • only here
- Acuity Specialty Hospital Ohio Valley, BELLAIRE • only here
An MS-DRG / APR-DRG price is the hospital’s single bundled charge for the entire inpatient stay — operating room, room & board, recovery, imaging, anesthesia (facility), implants and supplies — so it’s a broader, usually higher figure than the CPT/HCPCS 43259 line above, which prices the procedure alone. Neither includes the surgeon’s or anesthesiologist’s professional fees, which are billed separately.
Estimated complete episode
What the whole episode might cost
Your hospital facility price plus the separately-billed professional fees a complete episode adds. The facility figure is an actual negotiated rate from our data; the physician and sedation fees are estimated from the Medicare fee schedule scaled to commercial rates — not facility-specific quotes.
What hospitals actually negotiate
Measured
$1,638
$2,332 typical
$3,669
The middle 50% of negotiated facility rates for this procedure, measured across 2,268 hospitals. The physician and sedation fees are modeled estimates added on top.
What you’ll likely be billed
| Hospital facility Actual median across hospitals The hospital’s negotiated facility rate — from our MRF data. | $2,332 |
| Endoscopist (professional fee) Estimate national typical Medicare $199 × 1.22 commercial. | $242 |
| Anesthesia Estimate national typical 00731, ~30 min typical. Medicare $143 × 3.14 commercial. | $451 |
| Likely subtotal | $3,025 |
Complete-episode estimate (typical)
~$3,025
Not included in this estimate:
- Rehab, physical therapy, and other post-acute care after discharge (see the recovery plan below)
- Complications, revisions, or readmissions
- Out-of-network provider choices you make yourself (the No Surprises Act only covers providers you can't choose)
The biggest swing: whether a finding is treated during the same procedure, which converts a diagnostic exam to a therapeutic one and changes the cost-sharing.
Your recovery plan — adjust to what your doctor told you
After your procedure, recovery care is billed separately. We pre-fill the typical plan; change it to your situation.
Recovery cost modeled
~$3,785
With your recovery plan (typical)
~$6,810
How each figure is sourced
- Hospital facility (actual)
- source: Hospital MRF (45 CFR 180)
- Endoscopist (professional fee) (estimate)
- rvu_version: RVU26A (updated 2025-12-29) · gpci: National (unadjusted, GPCI = 1.000) · cf_rule: CMS-1832-F ($33.40) · multiplier_source: HCCI 2017 national
- Anesthesia (estimate)
- base_units_version: CY2022 file (base units unchanged for CY2026 per CMS) · anesthesia_cf: $20.49754 (National) · cf_rule: CMS-1832-F · multiplier_source: AJMC/Duffy 2016-2017 (PMID 34156223) national
Estimates use CMS Medicare Physician Fee Schedule reference data (RVU × GPCI × conversion factor; anesthesia base+time × CF) scaled by a sourced commercial multiplier, weighted by how often each component is billed. See the methodology. Your real total appears on your insurer’s Explanation of Benefits (EOB).
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 |
|---|---|---|---|---|---|---|---|
| SPRINGHILL MEDICAL CENTER Outpatient | Unitedhealthcare Insurance Company (Contracting On Behalf Of Itself, Unitedhealthcare Of Alabama, Inc. And United'S Affiliates) | Commercial All Payer | — | $2,104.96 | $1,789.22 | 2026-07-15 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Aetna | Commercial | — | $3,621.00 | $2,172.60 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Longevity | Medicare Advantage | — | $3,621.00 | $2,172.60 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Healthy Blue | Managed Medicaid | — | $3,621.00 | $2,172.60 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Humana Choicecare | Medicare Advantage | — | $3,621.00 | $2,172.60 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Blue Medicare Partner Health Plan | Medicare | — | $3,621.00 | $2,172.60 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Humana Choicecare | Commercial | — | $3,621.00 | $2,172.60 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Aetna | Medicare Advantage | — | $3,621.00 | $2,172.60 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | New Hanover | Medicare Advantage | — | $3,621.00 | $2,172.60 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Humana | Commercial | — | $3,621.00 | $2,172.60 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Aetna Nc State Health Plan | Commercial | — | $3,621.00 | $2,172.60 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Multiplan | Commercial | — | $3,621.00 | $2,172.60 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | United Healthcare | Compass | — | $3,621.00 | $2,172.60 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Wellcare | Medicare Advantage | — | $3,621.00 | $2,172.60 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | First Carolina Care | Medicare Advantage | — | $3,621.00 | $2,172.60 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Cigna | Commercial | — | $3,621.00 | $2,172.60 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Blue Cross Blue Shield Of Nc | Commercial | — | $3,621.00 | $2,172.60 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Wellcare | Managed Medicaid | — | $3,621.00 | $2,172.60 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | United Healthcare | Managed Medicaid | — | $3,621.00 | $2,172.60 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Carolina Complete Health | Managed Medicaid | — | $3,621.00 | $2,172.60 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Humana | Tricare | — | $3,621.00 | $2,172.60 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Medcost | Commercial | — | $3,621.00 | $2,172.60 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Humana | Medicare Advantage | — | $3,621.00 | $2,172.60 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Liberty Advantage | Medicare Advantage | — | $3,621.00 | $2,172.60 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Troy | Medicare Advantage | — | $3,621.00 | $2,172.60 | 2026-07-31 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $6.53 | $558.00 | $106.02 | 2026-01-25 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $6.53 | $763.00 | $144.97 | 2026-08-02 | MRF ↗ |
| RARITAN BAY MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $8.36 | $4,644.00 | $1,912.13 | 2024-12-31 | MRF ↗ |
| ADVENTIST HEALTH LODI MEMORIAL Outpatient | CELTIC INS COMPANY - ALL PLANS | CELTIC INS COMPANY - ALL PLANS | $15.00 | $763.00 | $53.41 | 2026-08-02 | MRF ↗ |
| ADVENTIST HEALTH LODI MEMORIAL Outpatient | KAISER MCAL | KAISER MCAL | $15.00 | $763.00 | $53.41 | 2026-08-02 | MRF ↗ |
| ADVENTIST HEALTH LODI MEMORIAL Outpatient | MEDI-CAL | MEDI-CAL | $15.00 | $763.00 | $53.41 | 2026-08-02 | MRF ↗ |
| ADVENTIST HEALTH LODI MEMORIAL Outpatient | BC MCAL | BC MCAL | $15.00 | $763.00 | $53.41 | 2026-08-02 | MRF ↗ |
| ADVENTIST HEALTH LODI MEMORIAL Outpatient | HP MCAL PRO FEE | HP MCAL PRO FEE | $16.50 | $763.00 | $53.41 | 2026-08-02 | MRF ↗ |
| ADVENTIST HEALTH LODI MEMORIAL Outpatient | HEALTHNET MCAL | HEALTHNET MCAL | $18.00 | $763.00 | $53.41 | 2026-08-02 | MRF ↗ |
| ADVENTIST HEALTH LODI MEMORIAL Outpatient | HP OF SAN JOAQUIN MCAL | HP OF SAN JOAQUIN MCAL | $18.00 | $763.00 | $53.41 | 2026-08-02 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCAL OP/PROFEE ONLY-ALL OTHER PLANS | DIGNITY MCAL OP/PROFEE ONLY-ALL OTHER PLANS | $20.00 | $763.00 | $144.97 | 2026-08-02 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | CAL VIVA HLTH MCAL - ALL PLANS | CAL VIVA HLTH MCAL - ALL PLANS | $20.00 | $763.00 | $144.97 | 2026-08-02 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | UPN MCAL PROFEE ONLY-ALL OTHER PLANS | UPN MCAL PROFEE ONLY-ALL OTHER PLANS | $20.00 | $763.00 | $144.97 | 2026-08-02 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | CENTRAL CA ALLIANCE MCAL PROFEE ONLY | CENTRAL CA ALLIANCE MCAL PROFEE ONLY | $20.00 | $763.00 | $144.97 | 2026-08-02 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | MEDI-CAL | MEDI-CAL | $20.00 | $763.00 | $144.97 | 2026-08-02 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | BC MCAL | BC MCAL | $20.00 | $763.00 | $144.97 | 2026-08-02 | MRF ↗ |
| CAREPOINT HEALTH - BAYONNE MEDICAL CENTER OutpatientFacility | UnitedHealthcare | Community & State | $20.09 | $833.65 | — | 2026-08-17 | MRF ↗ |
| CAREPOINT HEALTH - BAYONNE MEDICAL CENTER OutpatientFacility | Wellpoint | Medicaid Managed Care | $22.09 | $833.65 | — | 2026-08-17 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | KERN HEALTH SYSTEMS MCAL-ALL PLANS | KERN HEALTH SYSTEMS MCAL-ALL PLANS | $25.00 | $763.00 | $144.97 | 2026-08-02 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | CENTRAL CA ALLIANCE CCS PROFEE ONLY | CENTRAL CA ALLIANCE CCS PROFEE ONLY | $30.00 | $763.00 | $144.97 | 2026-08-02 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | CENTRAL CA ALLIANCE COMM PROFEE ONLY - ALL OTHER P | CENTRAL CA ALLIANCE COMM PROFEE ONLY - ALL OTHER P | $30.00 | $763.00 | $144.97 | 2026-08-02 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED CHICAGO TEACHER FUND-ALL PLANS | UNITED CHICAGO TEACHER FUND-ALL PLANS | $33.08 | $245.00 | $183.75 | 2026-01-16 | MRF ↗ |
| ADVENTIST HEALTH BAKERSFIELD Outpatient | UNIVERSAL HC MCAL PROFEE ONLY | UNIVERSAL HC MCAL PROFEE ONLY | $35.00 | $763.00 | $114.45 | 2026-10-05 | MRF ↗ |
| ADVENTIST HEALTH BAKERSFIELD Outpatient | BC MEDI-CAL | BC MEDI-CAL | $35.00 | $763.00 | $114.45 | 2026-10-05 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | CELTIC CA HLTH WELL MCAL - ALL PLANS | CELTIC CA HLTH WELL MCAL - ALL PLANS | $35.00 | $763.00 | $129.71 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | CENTRAL CA ALLIANCE MCAL | CENTRAL CA ALLIANCE MCAL | $35.00 | $763.00 | $129.71 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH BAKERSFIELD Outpatient | MEDI-CAL | MEDI-CAL | $35.00 | $763.00 | $114.45 | 2026-10-05 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | MEDI-CAL | MEDI-CAL | $35.00 | $763.00 | $129.71 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | HEALTHNET MCAL | HEALTHNET MCAL | $35.00 | $763.00 | $129.71 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | BC MCAL | BC MCAL | $35.00 | $763.00 | $129.71 | 2026-05-23 | MRF ↗ |
| FAIRCHILD MEDICAL CENTER Outpatient | MEDI-CAL | MEDI-CAL | $40.00 | $844.00 | $844.00 | 2026-09-24 | MRF ↗ |
| INDEPENDENCE HEALTH SYSTEM BUTLER MEMORIAL HOSPITA Outpatient | Ccbh - Behavioral Health | Behavioral | — | — | — | 2026-07-19 | MRF ↗ |
| ADVENTIST HEALTH UKIAH VALLEY Outpatient | KAISER MEDI-CAL | KAISER MEDI-CAL | $40.00 | $763.00 | $152.60 | 2026-05-24 | MRF ↗ |
| ADVENTIST HEALTH UKIAH VALLEY Outpatient | MEDI-CAL | MEDI-CAL | $40.00 | $763.00 | $152.60 | 2026-05-24 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | CENTRAL CA ALLIANCE CHDP PROFEE ONLY | CENTRAL CA ALLIANCE CHDP PROFEE ONLY | $40.00 | $763.00 | $144.97 | 2026-08-02 | MRF ↗ |
| ADVENTIST HEALTH BAKERSFIELD Outpatient | KERN HEALTH SYSTEMS MCAL | KERN HEALTH SYSTEMS MCAL | $49.35 | $763.00 | $114.45 | 2026-10-05 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED AT&T-ALL PLANS | UNITED AT&T-ALL PLANS | $50.84 | $245.00 | $183.75 | 2026-01-16 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | CENTRAL CA ALLIANCE COMM PROFEE ONLY-ALL OTHER PLA | CENTRAL CA ALLIANCE COMM PROFEE ONLY-ALL OTHER PLA | $52.50 | $763.00 | $129.71 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | CENTRAL CA ALLIANCE CCS MCAL | CENTRAL CA ALLIANCE CCS MCAL | $52.50 | $763.00 | $129.71 | 2026-05-23 | MRF ↗ |
| GUNNISON VALLEY HOSPITAL Outpatient | GUNNISON COUNTY SHERIFF OP & PROFEE ONLY | GUNNISON COUNTY SHERIFF OP & PROFEE ONLY | $53.90 | $105.00 | $89.25 | 2026-07-10 | MRF ↗ |
| WYNN HOSPITAL Outpatient | UNITED HEALTHCARE ALTERNATE [100260] | UHC EMPIRE ALTERNATE [10026001] | $60.90 | $8,531.01 | $5,118.61 | 2025-01-17 | MRF ↗ |
| GUNNISON VALLEY HOSPITAL Outpatient | U OF CO TRANSPLANT-ALL PLANS | U OF CO TRANSPLANT-ALL PLANS | $63.00 | $105.00 | $89.25 | 2026-07-10 | MRF ↗ |
| GUNNISON VALLEY HOSPITAL Outpatient | EBMS HDHP | EBMS HDHP | $63.00 | $105.00 | $89.25 | 2026-07-10 | MRF ↗ |
| GUNNISON VALLEY HOSPITAL Outpatient | TETWP OP & PROFEE ONLY-ALL PLANS | TETWP OP & PROFEE ONLY-ALL PLANS | $63.00 | $105.00 | $89.25 | 2026-07-10 | MRF ↗ |
| ADVENTIST HEALTH UKIAH VALLEY Outpatient | BLUE CROSS NON-MCS | BLUE CROSS NON-MCS | $66.41 | $763.00 | $152.60 | 2026-05-24 | MRF ↗ |
| ADVENTIST HEALTH UKIAH VALLEY Outpatient | BLUE CROSS MCS-ALL OTHER PLANS | BLUE CROSS MCS-ALL OTHER PLANS | $66.41 | $763.00 | $152.60 | 2026-05-24 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL Both | Blue Cross | Blue Access & Small Group | $69.60 | — | — | 2026-07-18 | MRF ↗ |
| BARNES JEWISH HOSPITAL Outpatient | HEALTHSCOPE BENEFITS [258] | BJC HB HEALTHSCOPE ORSCHELN BJH SLC | — | $7,889.70 | $4,733.82 | 2025-12-15 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | CENTRAL CA ALLIANCE CHDP MCAL | CENTRAL CA ALLIANCE CHDP MCAL | $70.00 | $763.00 | $129.71 | 2026-05-23 | MRF ↗ |
| BARNES JEWISH HOSPITAL Outpatient | UNITED HEALTHCARE [201] | BJC HB FIRST HEALTH | — | $7,889.70 | $4,733.82 | 2025-12-15 | MRF ↗ |
| BARNES JEWISH HOSPITAL Outpatient | HEALTHSCOPE BENEFITS [258] | BJC HB HEALTHSCOPE EGYPTIAN TRUST MHS PHC BJH | — | $7,889.70 | $4,733.82 | 2025-12-15 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $71.11 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Inpatient | SMARTHEALTH PPO | 8842_SMARTHEALTH PPO 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $71.11 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $71.11 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $71.11 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Outpatient | UNIFIED GROUP SERVICES | 8813_ANTHEM UNIFIED GROUPS VKIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $71.11 | — | — | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $71.11 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $71.11 | — | — | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Outpatient | UNIFIED GROUP SERVICES | 8812_ANTHEM UNIFIED GROUPS VHIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $71.11 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $71.11 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $71.11 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM PATHWAY | 9230_ANTHEM PATHWAY VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $71.11 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM HEALTHSYNC HMO | 9227_ANTHEM HEALTHSYNC HMO VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $71.11 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT JENNINGS Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $71.11 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $71.11 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $71.11 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $71.11 | — | — | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $71.11 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM HMO/POS | 9229_ANTHEM HMO POS VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM PPO PREFERRED | 9232_ANTHEM PREFERRED VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $71.11 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $71.11 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $71.11 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $71.11 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $71.11 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM PATHWAY X | 9231_ANTHEM PATHWAY X VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $71.11 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM SHORT TERM LIMITED DURATION | 9361_ANTHEM SHORT TERM LIMITED DURATION VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $71.11 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $71.11 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT JENNINGS Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $71.11 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $71.11 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $71.11 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $71.11 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $71.11 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $71.11 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $71.11 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $71.11 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $71.11 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT JENNINGS Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $71.11 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM HEALTHSYNC POS | 9228_ANTHEM HEALTHSYNC POS VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $71.11 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM TRADITIONAL | 9233_ANTHEM TRADITIONAL VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | UNITED HEALTH CARE COMMUNITY PLAN MEDICAID [9004] | UNITED HEALTH CARE MEDICAID [900401] | $71.25 | $578.00 | $578.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | UNITED HEALTH CARE COMMUNITY PLAN MEDICAID [9004] | UNITED HEALTH CARE MEDICAID [900401] | $71.25 | $578.00 | $578.00 | 2026-03-23 | MRF ↗ |
| SEARHC WRANGELL MEDICAL CENTER & LTC Outpatient | UHC-ALL PLANS | UHC-ALL PLANS | $72.00 | $1,162.51 | $1,162.51 | 2024-12-09 | MRF ↗ |
| GUNNISON VALLEY HOSPITAL Outpatient | EBMS PPO PLAN-ALL OTHER PLANS | EBMS PPO PLAN-ALL OTHER PLANS | $73.50 | $105.00 | $89.25 | 2026-07-10 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL Both | Blue Cross | Epo/Ppo/Hmo/Indemnity | $74.24 | — | — | 2026-07-18 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Arkansas Total Care | Medicaid | $76.46 | — | — | 2026-07-15 | MRF ↗ |
| CONCORD HOSPITAL Outpatient | Medicaid | Medicaid Nhhf | $78.02 | $849.00 | $254.70 | 2026-07-15 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | COUNTY HEALTH PLAN B [1022] | GENESEE HEALTH PLAN B [102204] | $78.38 | $578.00 | $578.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | KEY BENEFIT ADMINISTRATORS [1089] | KEY BENEFIT ADMINISTRATORS [108901] | $78.38 | $578.00 | $578.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | KEY BENEFIT ADMINISTRATORS [1089] | KEY BENEFIT ADMINISTRATORS [108901] | $78.38 | $578.00 | $578.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | COUNTY HEALTH PLAN B [1022] | COUNTY HEALTH PLAN B NON GENESEE COUNTY [102202] | $78.38 | $578.00 | $578.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | COUNTY HEALTH PLAN B [1022] | GENESEE HEALTH PLAN B [102204] | $78.38 | $578.00 | $578.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | COUNTY HEALTH PLAN B [1022] | COUNTY HEALTH PLAN B NON GENESEE COUNTY [102202] | $78.38 | $578.00 | $578.00 | 2026-03-23 | MRF ↗ |
| BELLEVUE MEDICAL CENTER Outpatient | AETNA COMM-ALL OTHER PLANS | AETNA COMM-ALL OTHER PLANS | $78.57 | $861.00 | $559.65 | 2026-08-10 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Caresource | Medicaid | $79.52 | — | — | 2026-07-15 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Tricare East Region DOS lt 01012025 | Federal | — | $2,939.15 | $1,675.32 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | UMR Wausau/UHIS | Default | — | $2,939.15 | $1,675.32 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Arizona Foundation for Medical Care (AFMC) | PPO | — | $2,939.15 | $1,675.32 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Tricare West | Default | — | $2,939.15 | $1,675.32 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Arizona Foundation for Medical Care (AFMC) | PPO | — | $2,939.15 | $1,675.32 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Aetna | Default | — | $2,939.15 | $1,675.32 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Aetna | Medicare Advantage | — | $2,939.15 | $1,675.32 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Sierra Health and Life MCR Adv | Medicare Advantage | — | $2,939.15 | $1,675.32 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Tricare West | Default | — | $2,939.15 | $1,675.32 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Presbyterian Health Plan MCR Adv | Medicare Advantage | — | $2,939.15 | $1,675.32 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | ASAGEHA | Federal | — | $2,939.15 | $1,675.32 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Medicare A AZ JF | Default | — | $2,939.15 | $1,675.32 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Presbyterian Health Plan MCR Adv | Medicare Advantage | — | $2,939.15 | $1,675.32 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Humana | Medicare Advantage | — | $2,939.15 | $1,675.32 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Medicare A AZ JF | Default | — | $2,939.15 | $1,675.32 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | UMR Wausau/UHIS | Default | — | $2,939.15 | $1,675.32 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Aetna | Default | — | $2,939.15 | $1,675.32 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Health Choice Pathway MCR Adv | Default | — | $2,939.15 | $1,675.32 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Cigna | Default | — | $2,939.15 | $1,675.32 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Great West Healthcare AZ | PPO | — | $2,939.15 | $1,675.32 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Humana | Medicare Advantage | — | $2,939.15 | $1,675.32 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | ASAGEHA | Federal | — | $2,939.15 | $1,675.32 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Cigna | Medicare Advantage | — | $2,939.15 | $1,675.32 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Cigna | Default | — | $2,939.15 | $1,675.32 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Blue Cross Blue Shield of AZ | Medicare Advantage | — | $2,939.15 | $1,675.32 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | VA Community Care Network VACCN Region 4 Triwest | Default | — | $2,939.15 | $1,675.32 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Blue Cross Blue Shield of AZ | Medicare Advantage | — | $2,939.15 | $1,675.32 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Blue Cross Blue Shield of AZ | Default | — | $2,939.15 | $1,675.32 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Blue Cross Blue Shield of AZ | Federal | — | $2,939.15 | $1,675.32 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | United Healthcare | Medicare Advantage | — | $2,939.15 | $1,675.32 | 2026-03-16 | MRF ↗ |
| BROOKWOOD BAPTIST MEDICAL CENTER Outpatient | Drummond | DrummondWorkersCompensation | $80.00 | — | — | 2024-12-11 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | United Healthcare | Default | — | $2,939.15 | $1,675.32 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Great West Healthcare AZ | PPO | — | $2,939.15 | $1,675.32 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | United Healthcare | Default | — | $2,939.15 | $1,675.32 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Cigna | Medicare Advantage | — | $2,939.15 | $1,675.32 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Blue Cross Blue Shield of AZ | Federal | — | $2,939.15 | $1,675.32 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Aetna | Medicare Advantage | — | $2,939.15 | $1,675.32 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Tricare East Region DOS lt 01012025 | Federal | — | $2,939.15 | $1,675.32 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Health Choice Pathway MCR Adv | Default | — | $2,939.15 | $1,675.32 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | United Healthcare | Medicare Advantage | — | $2,939.15 | $1,675.32 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Blue Cross Blue Shield of AZ | Default | — | $2,939.15 | $1,675.32 | 2026-03-16 | 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.