43405 — Ndl Sut Circ Rvrs 5.5
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). NDL SUT CIRC RVRS 5.5 (CDM 43405) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/43405?code_type=CDM
MLA (9th ed.)
“NDL SUT CIRC RVRS 5.5 (CDM 43405) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/43405?code_type=CDM. Accessed .
Chicago (notes-bibliography)
“NDL SUT CIRC RVRS 5.5 (CDM 43405) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/43405?code_type=CDM.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $59–$18,491 (25th–75th percentile) across 4 hospitals · 30 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CDM 43405 — 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 |
|---|---|---|---|---|---|---|---|
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | BCBS | BlueChoice | $22.32 | $155.00 | $155.00 | 2026-03-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | BCBS | Cap | $22.32 | $155.00 | $155.00 | 2026-03-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | United | OptionsPPO | $23.41 | $155.00 | $155.00 | 2026-03-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | Health Partners of Kansas | CignaLocalPlusNetwork | $26.82 | $155.00 | $155.00 | 2026-03-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | WPPA | WPPAPrimeNetwork | $26.97 | $155.00 | $155.00 | 2026-03-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | WPPA | ProviderCareNetwork | $26.97 | $155.00 | $155.00 | 2026-03-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | WPPA | UnifiedHealth | $26.97 | $155.00 | $155.00 | 2026-03-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | Aetna | LocalPreferred | $27.00 | $155.00 | $155.00 | 2026-03-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | Centene | HIX | $27.90 | $155.00 | $155.00 | 2026-03-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | Preferred Health Choices | COMM | $29.30 | $155.00 | $155.00 | 2026-03-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | Medical Associates Health Plan | COMM | $29.30 | $155.00 | $155.00 | 2026-03-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | Aetna | LocalOpen | $36.33 | $155.00 | $155.00 | 2026-03-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | Health Partners of Kansas | Non-LocalPlusandNon-ConnectCare | $36.58 | $155.00 | $155.00 | 2026-03-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | Aetna | NationalOpen | $37.20 | $155.00 | $155.00 | 2026-03-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | Aetna Better Health | MCD | $46.50 | $155.00 | $155.00 | 2026-03-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | Spirit Aerosystems | COMMOON | $49.60 | $155.00 | $155.00 | 2026-03-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | Aetna | Spirit | $55.34 | $155.00 | $155.00 | 2026-03-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | United | GlobalBenefitPlan | $69.75 | $155.00 | $155.00 | 2026-03-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | First Health | PPO | $71.45 | $155.00 | $155.00 | 2026-03-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | Health Partners of Kansas | Humana | $77.50 | $155.00 | $155.00 | 2026-03-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | Triwest Healthcare Alliance | Tricare | $100.75 | $155.00 | $155.00 | 2026-03-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | Multiplan | COMMPPOPRIMARYNETWORK | $108.50 | $155.00 | $155.00 | 2026-03-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | Multiplan | COMMPPOCOMPLEMENTARYNETWORK | $131.75 | $155.00 | $155.00 | 2026-03-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | USA Managed Care | COMM | $131.75 | $155.00 | $155.00 | 2026-03-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | Multiplan | BeechStreetCOMMPPO | $139.50 | $155.00 | $155.00 | 2026-03-01 | MRF ↗ |
| ST GABRIELS HOSPITAL Inpatient | BCBS - MN | Medicaid|All Plans | $384.31 | $1,281.03 | $743.00 | 2026-02-28 | MRF ↗ |
| ST GABRIELS HOSPITAL Outpatient | Health Partners | Medicare|All Plans | $422.74 | $1,281.03 | $743.00 | 2026-02-28 | MRF ↗ |
| ST GABRIELS HOSPITAL Outpatient | Medica | Medicare|All Plans | $443.88 | $1,281.03 | $743.00 | 2026-02-28 | MRF ↗ |
| ST GABRIELS HOSPITAL Outpatient | BCBS - MN | Medicare|All Plans | $461.18 | $1,281.03 | $743.00 | 2026-02-28 | MRF ↗ |
| ST GABRIELS HOSPITAL Outpatient | Humana | Medicare|All Plans | $461.18 | $1,281.03 | $743.00 | 2026-02-28 | MRF ↗ |
| ST GABRIELS HOSPITAL Outpatient | Health Partners | Medicaid|All Plans | $473.99 | $1,281.03 | $743.00 | 2026-02-28 | MRF ↗ |
| ST GABRIELS HOSPITAL Outpatient | Medica | Medicaid|All Plans | $473.99 | $1,281.03 | $743.00 | 2026-02-28 | MRF ↗ |
| ST GABRIELS HOSPITAL Outpatient | Ucare | Medicare|All Plans | $484.23 | $1,281.03 | $743.00 | 2026-02-28 | MRF ↗ |
| ST GABRIELS HOSPITAL Outpatient | Ucare | Medicaid|All Plans | $521.38 | $1,281.03 | $743.00 | 2026-02-28 | MRF ↗ |
| ST GABRIELS HOSPITAL Inpatient | BCBS - MN | Commercial|Federal Plans | $717.38 | $1,281.03 | $743.00 | 2026-02-28 | MRF ↗ |
| ST GABRIELS HOSPITAL Inpatient | BCBS - MN | Commercial|All Other Plans | $730.19 | $1,281.03 | $743.00 | 2026-02-28 | MRF ↗ |
| ST GABRIELS HOSPITAL Inpatient | Health Partners | Commercial|All Plans | $768.62 | $1,281.03 | $743.00 | 2026-02-28 | MRF ↗ |
| ST GABRIELS HOSPITAL Inpatient | United | Commercial|New Business | $935.16 | $1,281.03 | $743.00 | 2026-02-28 | MRF ↗ |
| ST GABRIELS HOSPITAL Inpatient | United | Commercial|All Other Plans | $1,024.83 | $1,281.03 | $743.00 | 2026-02-28 | MRF ↗ |
| ST GABRIELS HOSPITAL Inpatient | Ucare | Commercial|All Plans | $1,127.31 | $1,281.03 | $743.00 | 2026-02-28 | MRF ↗ |
| ST GABRIELS HOSPITAL Inpatient | Sanford Health Plan | Commercial|All Plans | $1,216.98 | $1,281.03 | $743.00 | 2026-02-28 | MRF ↗ |
| ST GABRIELS HOSPITAL Inpatient | MultiPlan | Commercial|All Plans | $1,216.98 | $1,281.03 | $743.00 | 2026-02-28 | MRF ↗ |
| WEST VALLEY MEDICAL CENTER Outpatient | Select Health Idaho (EIRMC only) | SelectMed | $9,568.09 | $29,994.00 | $29,994.00 | 2026-03-01 | MRF ↗ |
| WEST VALLEY MEDICAL CENTER Outpatient | Corizon Health | LOCALGOV | $11,097.78 | $29,994.00 | $29,994.00 | 2026-03-01 | MRF ↗ |
| WEST VALLEY MEDICAL CENTER Outpatient | True Blue | MCRHMO | $11,847.63 | $29,994.00 | $29,994.00 | 2026-03-01 | MRF ↗ |
| North Alabama Specialty Hospital Inpatient | Galaxy Health Network | Galaxy Health Network | — | $14,500.00 | $14,500.00 | 2025-07-02 | MRF ↗ |
| WEST VALLEY MEDICAL CENTER Outpatient | Cigna | PPO | $16,796.64 | $29,994.00 | $29,994.00 | 2026-03-01 | MRF ↗ |
| WEST VALLEY MEDICAL CENTER Outpatient | PacificSource Health | PPO | $17,906.42 | $29,994.00 | $29,994.00 | 2026-03-01 | MRF ↗ |
| WEST VALLEY MEDICAL CENTER Outpatient | United | OptionsPPO | $17,906.42 | $29,994.00 | $29,994.00 | 2026-03-01 | MRF ↗ |
| WEST VALLEY MEDICAL CENTER Outpatient | Moda | COMM | $18,686.26 | $29,994.00 | $29,994.00 | 2026-03-01 | MRF ↗ |
| WEST VALLEY MEDICAL CENTER Outpatient | St Luke's Health Partners | LARGEGROUP | $19,496.10 | $29,994.00 | $29,994.00 | 2026-03-01 | MRF ↗ |
| WEST VALLEY MEDICAL CENTER Outpatient | St Luke's Health Partners | QHP | $19,496.10 | $29,994.00 | $29,994.00 | 2026-03-01 | MRF ↗ |
| WEST VALLEY MEDICAL CENTER Outpatient | St Luke's Health Partners | MCR | $19,496.10 | $29,994.00 | $29,994.00 | 2026-03-01 | MRF ↗ |
| WEST VALLEY MEDICAL CENTER Outpatient | Aetna | COMM | $23,725.25 | $29,994.00 | $29,994.00 | 2026-03-01 | MRF ↗ |
| WEST VALLEY MEDICAL CENTER Outpatient | Four Rivers Hospice | MCR | $23,995.20 | $29,994.00 | $29,994.00 | 2026-03-01 | MRF ↗ |
| WEST VALLEY MEDICAL CENTER Outpatient | Multiplan | PRIMARY | $23,995.20 | $29,994.00 | $29,994.00 | 2026-03-01 | MRF ↗ |
| WEST VALLEY MEDICAL CENTER Outpatient | Multiplan | COMPLEMENTARY | $23,995.20 | $29,994.00 | $29,994.00 | 2026-03-01 | MRF ↗ |
| WEST VALLEY MEDICAL CENTER Outpatient | Humana ChoiceCare | COMM | $25,194.96 | $29,994.00 | $29,994.00 | 2026-03-01 | MRF ↗ |
| WEST VALLEY MEDICAL CENTER Outpatient | GEHA PPO USA | COMM | $25,494.90 | $29,994.00 | $29,994.00 | 2026-03-01 | MRF ↗ |
| WEST VALLEY MEDICAL CENTER Outpatient | Coventry First Health | COMM | $26,994.60 | $29,994.00 | $29,994.00 | 2026-03-01 | MRF ↗ |
| WEST VALLEY MEDICAL CENTER Outpatient | St Alphonsus Health | PPO | $26,994.60 | $29,994.00 | $29,994.00 | 2026-03-01 | MRF ↗ |
| WEST VALLEY MEDICAL CENTER Outpatient | Coventry First Health | WCOMP | $26,994.60 | $29,994.00 | $29,994.00 | 2026-03-01 | MRF ↗ |
| WEST VALLEY MEDICAL CENTER Outpatient | St Alphonsus Health | COMM | $26,994.60 | $29,994.00 | $29,994.00 | 2026-03-01 | MRF ↗ |
| WEST VALLEY MEDICAL CENTER Outpatient | Blue Cross | QHP | $28,494.30 | $29,994.00 | $29,994.00 | 2026-03-01 | MRF ↗ |
| WEST VALLEY MEDICAL CENTER Outpatient | Blue Cross | ConnectedCare | $28,494.30 | $29,994.00 | $29,994.00 | 2026-03-01 | MRF ↗ |
| WEST VALLEY MEDICAL CENTER Outpatient | Blue Cross | QEP | $28,494.30 | $29,994.00 | $29,994.00 | 2026-03-01 | MRF ↗ |