50242004413_2 — Alteplase For Pulmonary Embolism 50 Mg
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). ALTEPLASE FOR PULMONARY EMBOLISM 50 MG (NDC 50242004413_2) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/50242004413_2?code_type=NDC
MLA (9th ed.)
“ALTEPLASE FOR PULMONARY EMBOLISM 50 MG (NDC 50242004413_2) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/50242004413_2?code_type=NDC. Accessed .
Chicago (notes-bibliography)
“ALTEPLASE FOR PULMONARY EMBOLISM 50 MG (NDC 50242004413_2) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/50242004413_2?code_type=NDC.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $2–$6,146 (25th–75th percentile) across 8 hospitals · 32 payers.
“Negotiated” is the hospital’s negotiated facility rate for this NDC 50242004413_2 — 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 |
|---|---|---|---|---|---|---|---|
| SAMARITAN LEBANON COMMUNITY HOSPITAL BothFacility | PROVIDENCE | MEDICARE ADV. | $0.87 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL BothFacility | PROVIDENCE | MA-BEHAVIORAL HEALTH | $0.87 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL OutpatientFacility | SAMARITAN | MEDICARE ADV. | $0.88 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL OutpatientFacility | HEALTHNET | MEDICARE ADV. | $0.96 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL OutpatientFacility | REGENCE | MEDICARE ADV. | $0.96 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL OutpatientFacility | PACIFICSOURCE | MEDICARE ADV. | $0.97 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | PROVIDENCE | MEDICARE ADV. | $0.99 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | PROVIDENCE | MEDICARE ADV. | $0.99 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL OutpatientFacility | DEVOTED HEALTH | DEVOTED HEALTH MCR ADVANTAGE | $1.00 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | HUMANA | MEDICARE ADV. | $1.00 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | SAMARITAN | MEDICARE ADV. | $1.00 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | HUMANA | MEDICARE ADV. | $1.00 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | SAMARITAN | MEDICARE ADV. | $1.00 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL OutpatientFacility | PROVIDENCE | MEDICARE ADV. | $1.08 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | REGENCE | MEDICARE ADV. | $1.09 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL OutpatientFacility | SAMARITAN | MEDICARE ADV. | $1.09 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | REGENCE | MEDICARE ADV. | $1.09 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | PACIFICSOURCE | MEDICARE ADV. | $1.11 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | PACIFICSOURCE | MEDICARE ADV. | $1.11 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | DEVOTED HEALTH | DEVOTED HEALTH MCR ADVANTAGE | $1.14 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | DEVOTED HEALTH | DEVOTED HEALTH MCR ADVANTAGE | $1.14 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL OutpatientFacility | REGENCE | MEDICARE ADV. | $1.19 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL OutpatientFacility | PACIFICSOURCE | MEDICARE ADV. | $1.21 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL OutpatientFacility | DEVOTED HEALTH | DEVOTED HEALTH MCR ADVANTAGE | $1.24 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| GOOD SAMARITAN REGIONAL MEDICAL CENTER OutpatientFacility | SAMARITAN | MEDICARE ADV. | $1.50 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN ALBANY GENERAL HOSPITAL OutpatientFacility | SAMARITAN | MEDICARE ADV. | $1.50 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN ALBANY GENERAL HOSPITAL OutpatientFacility | PROVIDENCE | MEDICARE ADV. | $2.01 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| GOOD SAMARITAN REGIONAL MEDICAL CENTER OutpatientFacility | PROVIDENCE | MEDICARE ADV. | $2.01 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL BothFacility | SAMARITAN | EPO | $2.10 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | HAP | Self Insured | $2.10 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | SAMARITAN | EPO | $2.10 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | SAMARITAN | EPO | $2.10 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL BothFacility | SAMARITAN | EPO | $2.10 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| GOOD SAMARITAN REGIONAL MEDICAL CENTER OutpatientFacility | PACIFICSOURCE | MEDICARE ADV. | $2.10 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| GOOD SAMARITAN REGIONAL MEDICAL CENTER BothFacility | SAMARITAN | SAMARITAN CHOICE | $2.40 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | SAMARITAN | SAMARITAN CHOICE | $2.40 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL BothFacility | SAMARITAN | SAMARITAN CHOICE | $2.40 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | SAMARITAN | SAMARITAN CHOICE | $2.40 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN ALBANY GENERAL HOSPITAL BothFacility | SAMARITAN | SAMARITAN CHOICE | $2.40 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL BothFacility | SAMARITAN | SAMARITAN CHOICE | $2.40 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| GOOD SAMARITAN REGIONAL MEDICAL CENTER BothFacility | REGENCE | ALL PRODUCTS | $2.53 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN ALBANY GENERAL HOSPITAL BothFacility | REGENCE | ALL PRODUCTS | $2.53 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | SAMARITAN | SAMARITAN GROUP | $2.55 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | SAMARITAN | SAMARITAN GROUP | $2.55 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL BothFacility | SAMARITAN | SAMARITAN GROUP | $2.55 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL BothFacility | SAMARITAN | SAMARITAN GROUP | $2.55 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | REGENCE | ALL PRODUCTS | $2.70 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL BothFacility | REGENCE | ALL PRODUCTS | $2.70 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | REGENCE | ALL PRODUCTS | $2.70 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL BothFacility | REGENCE | ALL PRODUCTS | $2.70 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| GOOD SAMARITAN REGIONAL MEDICAL CENTER OutpatientFacility | PROVIDENCE | INDIVIDUAL-STANDARD | $2.82 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | MODA | CONNEXUS-SYNERGY-OHSU PPO | $2.85 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | AETNA | ALL PRODUCTS | $2.85 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN ALBANY GENERAL HOSPITAL BothFacility | AETNA | ALL PRODUCTS | $2.85 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | MODA | CONNEXUS-SYNERGY-OHSU PPO | $2.85 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN ALBANY GENERAL HOSPITAL BothFacility | CIGNA | ALL PRODUCTS | $2.85 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| GOOD SAMARITAN REGIONAL MEDICAL CENTER BothFacility | CIGNA | ALL PRODUCTS | $2.85 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| GOOD SAMARITAN REGIONAL MEDICAL CENTER BothFacility | AETNA | ALL PRODUCTS | $2.85 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL BothFacility | MODA | CONNEXUS-SYNERGY-OHSU PPO | $2.85 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL BothFacility | AETNA | ALL PRODUCTS | $2.85 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | AETNA | ALL PRODUCTS | $2.85 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL BothFacility | AETNA | ALL PRODUCTS | $2.85 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL OutpatientFacility | PROVIDENCE | EPO - NON PEBB/OEBB | $2.91 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL OutpatientFacility | PROVIDENCE | INDIVIDUAL-STANDARD | $2.91 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL OutpatientFacility | PROVIDENCE | EPO - PEBB/OEBB | $2.91 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN ALBANY GENERAL HOSPITAL OutpatientFacility | PROVIDENCE | EPO - NON PEBB/OEBB | $2.91 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | PROVIDENCE | EPO - PEBB/OEBB | $2.91 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | CIGNA | ALL PRODUCTS | $2.91 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | PROVIDENCE | EPO - NON PEBB/OEBB | $2.91 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | PROVIDENCE | INDIVIDUAL-STANDARD | $2.91 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | HEALTHNET | ALL PRODUCTS | $2.91 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | HEALTHNET | ALL PRODUCTS | $2.91 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | CIGNA | ALL PRODUCTS | $2.91 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | PROVIDENCE | EPO - PEBB/OEBB | $2.91 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | PROVIDENCE | INDIVIDUAL-STANDARD | $2.91 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | PROVIDENCE | EPO - NON PEBB/OEBB | $2.91 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL BothFacility | HEALTHNET | ALL PRODUCTS | $2.91 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL BothFacility | CIGNA | ALL PRODUCTS | $2.91 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL BothFacility | CIGNA | ALL PRODUCTS | $2.91 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL BothFacility | HEALTHNET | ALL PRODUCTS | $2.91 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| GOOD SAMARITAN REGIONAL MEDICAL CENTER OutpatientFacility | PROVIDENCE | EPO - NON PEBB/OEBB | $2.91 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| GOOD SAMARITAN REGIONAL MEDICAL CENTER BothFacility | HEALTHNET | ALL PRODUCTS | $2.91 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL OutpatientFacility | PROVIDENCE | EPO - NON PEBB/OEBB | $2.91 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL OutpatientFacility | PROVIDENCE | EPO - PEBB/OEBB | $2.91 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL OutpatientFacility | PROVIDENCE | INDIVIDUAL-STANDARD | $2.91 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN ALBANY GENERAL HOSPITAL BothFacility | HEALTHNET | ALL PRODUCTS | $2.91 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | HUMANA | ALL PRODUCTS | $2.93 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | HUMANA | ALL PRODUCTS | $2.93 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| GOOD SAMARITAN REGIONAL MEDICAL CENTER BothFacility | HUMANA | ALL PRODUCTS | $2.93 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN ALBANY GENERAL HOSPITAL BothFacility | HUMANA | ALL PRODUCTS | $2.93 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL BothFacility | HUMANA | ALL PRODUCTS | $2.93 | $3.00 | $2.40 | 2026-01-31 | MRF ↗ |
| STRAUB CLINIC AND HOSPITAL OutpatientFacility | BLENDED RATE UHC | ALL PRODUCTS | $2,356.03 | $10,243.63 | $6,146.18 | 2026-02-12 | MRF ↗ |
| STRAUB CLINIC AND HOSPITAL OutpatientFacility | ALOHACARE | NON-ABD - PEDIATRIC | $3,004.46 | $10,243.63 | $6,146.18 | 2026-02-12 | MRF ↗ |
| STRAUB CLINIC AND HOSPITAL OutpatientFacility | ALOHACARE | NON-ABD - ADULT | $3,004.46 | $10,243.63 | $6,146.18 | 2026-02-12 | MRF ↗ |
| STRAUB CLINIC AND HOSPITAL OutpatientFacility | OHANA | QUEST - NON-ABD | $3,052.60 | $10,243.63 | $6,146.18 | 2026-02-12 | MRF ↗ |
| STRAUB CLINIC AND HOSPITAL OutpatientFacility | OHANA | ABD | $3,052.60 | $10,243.63 | $6,146.18 | 2026-02-12 | MRF ↗ |
| STRAUB CLINIC AND HOSPITAL OutpatientFacility | OHANA | NON-ABD | $3,052.60 | $10,243.63 | $6,146.18 | 2026-02-12 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | MOLINA | MARKETPLACE | $3,961.66 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | Molina MI Health Link | MEDICARE ADVANTAGE | $3,961.66 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | Molina MI Health Link | MEDICARE ADVANTAGE | $3,961.66 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | MOLINA | MARKETPLACE | $3,961.66 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | WellCare | Medicare Advantage | $3,988.07 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | WellCare | Medicare Advantage | $4,735.51 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| STRAUB CLINIC AND HOSPITAL OutpatientFacility | ALOHACARE | ABD - PEDIATRIC | $6,008.91 | $10,243.63 | $6,146.18 | 2026-02-12 | MRF ↗ |
| STRAUB CLINIC AND HOSPITAL OutpatientFacility | ALOHACARE | ABD - ADULT | $6,008.91 | $10,243.63 | $6,146.18 | 2026-02-12 | MRF ↗ |
| STRAUB CLINIC AND HOSPITAL BothFacility | VERDEGARD | UNION TRUST FUND | $6,146.18 | $10,243.63 | $6,146.18 | 2026-02-12 | MRF ↗ |
| STRAUB CLINIC AND HOSPITAL BothFacility | HCHA | ALL PRODUCTS | $6,146.18 | $10,243.63 | $6,146.18 | 2026-02-12 | MRF ↗ |
| STRAUB CLINIC AND HOSPITAL BothFacility | MDX | ALL PRODUCTS | $6,146.18 | $10,243.63 | $6,146.18 | 2026-02-12 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | VitalCore Physicians Group of MI | All Products | $6,602.77 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | VitalCore Physicians Group of MI | All Products | $6,602.77 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | HAP | Fully Insured | $6,844.43 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | NFL Health Services - Cigna | ALL PRODUCTS | $6,866.88 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | NFL Health Services - Cigna | ALL PRODUCTS | $6,866.88 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital BothFacility | Priority Health | HMO/PPO | $7,084.77 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| STRAUB CLINIC AND HOSPITAL InpatientFacility | PAC ADMIN | ALL PRODUCTS | $7,170.54 | $10,243.63 | $6,146.18 | 2026-02-12 | MRF ↗ |
| STRAUB CLINIC AND HOSPITAL BothFacility | HWMG/HMAA | ALL PRODUCTS | $7,170.54 | $10,243.63 | $6,146.18 | 2026-02-12 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | HAP | Fully Insured | $7,228.71 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL BothFacility | Priority Health | HMO/PPO | $7,253.80 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL BothFacility | McLaren Health | Commercial HMO | $7,619.60 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL BothFacility | McLaren Health | Health Advantage PPO | $7,619.60 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| STRAUB CLINIC AND HOSPITAL OutpatientFacility | MIMOH | ALL PRODUCTS | $7,682.72 | $10,243.63 | $6,146.18 | 2026-02-12 | MRF ↗ |
| STRAUB CLINIC AND HOSPITAL OutpatientFacility | CALVOS | SELECT CARE | $7,682.72 | $10,243.63 | $6,146.18 | 2026-02-12 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | Cigna Transplants | ALL PRODUCTS | $7,791.27 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital BothFacility | Ontario Ministry of Health and Long-Term Care | ALL PRODUCTS | $7,923.32 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital BothFacility | McLaren Health | Health Advantage PPO | $8,023.69 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital BothFacility | McLaren Health | Commercial HMO | $8,023.69 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| STRAUB CLINIC AND HOSPITAL InpatientFacility | MULTIPLAN | ALL PRODUCTS | $8,194.90 | $10,243.63 | $6,146.18 | 2026-02-12 | MRF ↗ |
| STRAUB CLINIC AND HOSPITAL OutpatientFacility | KAISER | ALL PRODUCTS | $8,194.90 | $10,243.63 | $6,146.18 | 2026-02-12 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | AETNA | ALL PRODUCTS | $8,253.46 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | AETNA | ALL PRODUCTS | $8,372.31 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | Humana Transplants | ALL PRODUCTS | $8,583.60 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | Humana Transplants | MEDICARE ADVANTAGE | $8,583.60 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| STRAUB CLINIC AND HOSPITAL BothFacility | MULTIPLAN | ALL PRODUCTS | $8,707.09 | $10,243.63 | $6,146.18 | 2026-02-12 | MRF ↗ |
| Henry Ford Hospital BothFacility | MULTIPLAN, INC. | Complementary Network | $8,847.71 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL BothFacility | MULTIPLAN, INC. | Complementary Network | $8,847.71 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital BothFacility | Priority Cigna | ALL PRODUCTS | $8,901.85 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | HAP | Self Insured | $9,399.70 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | University of Michigan | ALL PRODUCTS | $10,564.43 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | University of Michigan | ALL PRODUCTS | $10,564.43 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL BothFacility | Priority Cigna | ALL PRODUCTS | $10,734.78 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital BothFacility | Cofinity Group Health | ALL PRODUCTS | $11,383.18 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | Cofinity Group Health | ALL PRODUCTS | $11,383.18 | $13,205.54 | — | 2025-06-28 | MRF ↗ |