5005608 — Dvc Amulet 12f 18mm Ide G190285
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). DVC AMULET 12F 18MM IDE G190285 (CDM 5005608) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/5005608?code_type=CDM
MLA (9th ed.)
“DVC AMULET 12F 18MM IDE G190285 (CDM 5005608) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/5005608?code_type=CDM. Accessed .
Chicago (notes-bibliography)
“DVC AMULET 12F 18MM IDE G190285 (CDM 5005608) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/5005608?code_type=CDM.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $362–$24,499 (25th–75th percentile) across 3 hospitals · 31 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CDM 5005608 — 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 |
|---|---|---|---|---|---|---|---|
| Ascension Macomb-Oakland Hospital Madison Heights Campus Outpatient | MAGELLAN BEHAVIORAL | 1784_SJMA SJMC MAGELLAN BEHAVIORAL 20200101 | $118.80 | $396.00 | $221.76 | 2026-01-01 | MRF ↗ |
| Ascension Macomb-Oakland Hospital Madison Heights Campus Outpatient | PRIORITY PPO | 2009_PRIORITY PPO 20210801 | $154.44 | $396.00 | $221.76 | 2026-01-01 | MRF ↗ |
| Ascension Macomb-Oakland Hospital Madison Heights Campus Outpatient | HAP HMO | 2174_SJMA HEALTH ALLIANCE HMO 20241001 | $158.40 | $396.00 | $221.76 | 2026-01-01 | MRF ↗ |
| Ascension Macomb-Oakland Hospital Madison Heights Campus Outpatient | HAP HMO | 2166_HEALTH ALLIANCE HMO 20241001 | $158.40 | $396.00 | $221.76 | 2026-01-01 | MRF ↗ |
| Ascension Macomb-Oakland Hospital Madison Heights Campus Outpatient | AHLIC | 2163_AHLIC 20241001 | $158.40 | $396.00 | $221.76 | 2026-01-01 | MRF ↗ |
| Ascension Macomb-Oakland Hospital Madison Heights Campus Outpatient | CIGNA | 2014_SJRD,SJMC CIGNA 20210701 | $162.36 | $396.00 | $221.76 | 2026-01-01 | MRF ↗ |
| Ascension Macomb-Oakland Hospital Madison Heights Campus Outpatient | PRIORITY HMO | 2010_PRIORITY HMO 20210701 | $162.36 | $396.00 | $221.76 | 2026-01-01 | MRF ↗ |
| Ascension Macomb-Oakland Hospital Madison Heights Campus Outpatient | HOSPICE | 447_SJMA, SJMC HOSPICE 20160101 | $198.00 | $396.00 | $221.76 | 2026-01-01 | MRF ↗ |
| Ascension Macomb-Oakland Hospital Madison Heights Campus Outpatient | HAP PREFERRED | 2171_HAP PREFERRED (PHP) 20241001 | $253.44 | $396.00 | $221.76 | 2026-01-01 | MRF ↗ |
| Ascension Macomb-Oakland Hospital Madison Heights Campus Outpatient | HEALTHPLUS PPO | 990_HEALTHPLUS PPO 20200101 | $257.40 | $396.00 | $221.76 | 2026-01-01 | MRF ↗ |
| Ascension Macomb-Oakland Hospital Madison Heights Campus Outpatient | AETNA PPO | 2136_AETNA 20241001 | $273.24 | $396.00 | $221.76 | 2026-01-01 | MRF ↗ |
| Ascension Macomb-Oakland Hospital Madison Heights Campus Outpatient | PHCS POS | 1311_PHCS POS 20201001 | $277.20 | $396.00 | $221.76 | 2026-01-01 | MRF ↗ |
| Ascension Macomb-Oakland Hospital Madison Heights Campus Outpatient | PHCS PPO | 1457_PHCS PPO 20201001 | $297.00 | $396.00 | $221.76 | 2026-01-01 | MRF ↗ |
| Ascension Macomb-Oakland Hospital Madison Heights Campus Outpatient | PHCS PPO GREAT WEST & MAILHANDLERS | 1458_PHCS PPO GR WEST & MAILHANDLERS 20201001 | $297.00 | $396.00 | $221.76 | 2026-01-01 | MRF ↗ |
| Ascension Macomb-Oakland Hospital Madison Heights Campus Outpatient | PPOM | 934_PPOM 20191001 | $350.70 | $396.00 | $221.76 | 2026-01-01 | MRF ↗ |
| Ascension Macomb-Oakland Hospital Madison Heights Campus Both | CDM DEFAULT - NON-NEGOTIATED RATE | CDM DEFAULT - NON-NEGOTIATED RATE | $396.00 | $396.00 | $221.76 | 2026-01-01 | MRF ↗ |
| Ascension Macomb-Oakland Hospital Madison Heights Campus Outpatient | BCCCP | 1782_BCCCP 20210201 | $396.00 | $396.00 | $221.76 | 2026-01-01 | MRF ↗ |
| OCHILTREE GENERAL HOSPITAL Outpatient | Aetna | Medicare Advantage | $6,423.00 | $13,108.00 | $9,176.00 | 2026-05-06 | MRF ↗ |
| OCHILTREE GENERAL HOSPITAL Outpatient | Superior Health Plan | Commercial | $6,423.00 | $13,108.00 | $9,176.00 | 2026-05-06 | MRF ↗ |
| OCHILTREE GENERAL HOSPITAL Outpatient | Humana | Medicare Advantage | $6,423.00 | $13,108.00 | $9,176.00 | 2026-05-06 | MRF ↗ |
| ASCENSION ST VINCENT'S RIVERSIDE Outpatient | NORTH FLORIDA SURGEONS | 610_NORTH FLORIDA SURGEONS | $10,000.00 | $61,632.00 | $22,803.84 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT'S RIVERSIDE Outpatient | BLUE CROSS MBN | 1584_BLUE CROSS BLUE SHIELD MBN 20250701 | $11,093.76 | $61,632.00 | $22,803.84 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT'S RIVERSIDE Outpatient | BLUE CROSS BSL | 1583_BLUE CROSS BLUE SHIELD BSL 20250701 | $11,093.76 | $61,632.00 | $22,803.84 | 2026-01-01 | MRF ↗ |
| OCHILTREE GENERAL HOSPITAL Outpatient | Aetna | Commercial | $11,142.00 | $13,108.00 | $9,176.00 | 2026-05-06 | MRF ↗ |
| OCHILTREE GENERAL HOSPITAL Outpatient | Blue Cross Blue Shield of Texas | Commercial | $11,797.00 | $13,108.00 | $9,176.00 | 2026-05-06 | MRF ↗ |
| OCHILTREE GENERAL HOSPITAL Outpatient | Blue Cross Blue Shield of Texas | PPO | $11,797.00 | $13,108.00 | $9,176.00 | 2026-05-06 | MRF ↗ |
| OCHILTREE GENERAL HOSPITAL Outpatient | Cigna | Commercial | $11,797.00 | $13,108.00 | $9,176.00 | 2026-05-06 | MRF ↗ |
| OCHILTREE GENERAL HOSPITAL Outpatient | FirstCare | Commercial | $11,797.00 | $13,108.00 | $9,176.00 | 2026-05-06 | MRF ↗ |
| ASCENSION ST VINCENT'S RIVERSIDE Outpatient | GEORGIA MEDICAID | 1494_MEDICAID REPLACEMENT GEORGIA 20240901 | $12,326.40 | $61,632.00 | $22,803.84 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT'S RIVERSIDE Outpatient | CIGNA HMO NEW BUSINESS | 1594_CIGNA HMO NEW BUSINESS 20250701 | $12,326.40 | $61,632.00 | $22,803.84 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT'S RIVERSIDE Outpatient | BLUE CROSS SBN | 1586_BLUE CROSS BLUE SHIELD SBN 20250701 | $13,559.04 | $61,632.00 | $22,803.84 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT'S RIVERSIDE Outpatient | BLUE CROSS HMO | 1585_BLUE CROSS BLUE SHIELD HMO 20250701 | $13,559.04 | $61,632.00 | $22,803.84 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT'S RIVERSIDE Outpatient | BLUE CROSS NWB | 1587_BLUE CROSS BLUE SHIELD NWB 20250701 | $14,791.68 | $61,632.00 | $22,803.84 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT'S RIVERSIDE Outpatient | HUMANA PPO | 1573_HUMANA PPO 20250101 | $17,256.96 | $61,632.00 | $22,803.84 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT'S RIVERSIDE Outpatient | HUMANA HMO | 1572_HUMANA HMO 20250101 | $17,256.96 | $61,632.00 | $22,803.84 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT'S RIVERSIDE Outpatient | AVMED NEW BUSINESS | 1442_AVMED NEW BUSINESS 20240701 | $17,873.28 | $61,632.00 | $22,803.84 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT'S RIVERSIDE Outpatient | BLUE CROSS PPO | 1589_BLUE CROSS BLUE SHIELD PPO 20250701 | $18,489.60 | $61,632.00 | $22,803.84 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT'S RIVERSIDE Outpatient | AHF MCO | 431_AHF MCO 20140101 | $20,338.56 | $61,632.00 | $22,803.84 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT'S RIVERSIDE Outpatient | AVMED | 1581_AVMED BROAD 20250701 | $21,571.20 | $61,632.00 | $22,803.84 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT'S RIVERSIDE Outpatient | NORTHWELL DIRECT | 1543_NORTHWELL DIRECT 20241001 | $21,571.20 | $61,632.00 | $22,803.84 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT'S RIVERSIDE Outpatient | CIGNA PPO | 1593_CIGNA PPO 20250701 | $22,803.84 | $61,632.00 | $22,803.84 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT'S RIVERSIDE Outpatient | CIGNA HMO | 1592_CIGNA HMO 20250701 | $22,803.84 | $61,632.00 | $22,803.84 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT'S RIVERSIDE Outpatient | AETNA | 1576_AETNA RIVER 20250701 | $24,036.48 | $61,632.00 | $22,803.84 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT'S RIVERSIDE Outpatient | COVENTRY PPO HIGH PERFORMANCE | 1508_COVENTRY PPO AND HIGH PERFORMANCE 20241001 | $24,652.80 | $61,632.00 | $22,803.84 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT'S RIVERSIDE Outpatient | UHC HMO | 1591_UNITED HEALTH CARE 20250701 | $25,269.12 | $61,632.00 | $22,803.84 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT'S RIVERSIDE Outpatient | 90 DEGREE BENEFITS | 1517_90 DEGREE BENEFITS OUTPATIENT 20250101 | $30,816.00 | $61,632.00 | $22,803.84 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT'S RIVERSIDE Outpatient | AETNA SIGNATURE ADMIN | 339_AETNA SIGNATURE ADMINISTRATORS 20160701 | $31,432.32 | $61,632.00 | $22,803.84 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT'S RIVERSIDE Outpatient | BLUE CROSS PHS | 1588_BLUE CROSS BLUE SHIELD PHS 20250701 | $31,432.32 | $61,632.00 | $22,803.84 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT'S RIVERSIDE Outpatient | COVENTRY HMO | 1507_COVENTRY HMO 20241001 | $36,362.88 | $61,632.00 | $22,803.84 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT'S RIVERSIDE Outpatient | FIRST HEALTH | 1305_FIRST HEALTH COVENTRY 20230701 | $36,979.20 | $61,632.00 | $22,803.84 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT'S RIVERSIDE Outpatient | SE GEORGIA HEALTH SYSTEMS | 1236_SE GEORGIA HEALTH SYSTEM 20220601 | $36,979.20 | $61,632.00 | $22,803.84 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT'S RIVERSIDE Outpatient | PHCS | 303_PHCS 20020901 | $36,979.20 | $61,632.00 | $22,803.84 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT'S RIVERSIDE Outpatient | COVENTRY WC | 1407_COVENTRY WORKERS COMPENSATION 20230715 | $40,060.80 | $61,632.00 | $22,803.84 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT'S RIVERSIDE Outpatient | UHC PPO | 947_UNITED HEALTH CARE PPO 20210101 | $44,991.36 | $61,632.00 | $22,803.84 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT'S RIVERSIDE Outpatient | MULTIPLAN | 344_MULTIPLAN 20160101 | $49,305.60 | $61,632.00 | $22,803.84 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT'S RIVERSIDE Outpatient | BEECH STREET | 436_BEECHSTREET 20160101 | $52,387.20 | $61,632.00 | $22,803.84 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT'S RIVERSIDE Both | CDM DEFAULT - NON-NEGOTIATED RATE | CDM DEFAULT - NON-NEGOTIATED RATE | $61,632.00 | $61,632.00 | $22,803.84 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT'S RIVERSIDE Outpatient | HEARTLAND HOME HEALTH AND HOSPICE | 458_MEDICARE ADVANTAGE HEARTLAND HOME HEALTH AND HOSPICE INPATIENT 20090201 | $61,632.00 | $61,632.00 | $22,803.84 | 2026-01-01 | MRF ↗ |