58740 — Adhesiolysis Tube Ovary
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). Adhesiolysis tube ovary (OTHER 58740) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/58740?code_type=OTHER
MLA (9th ed.)
“Adhesiolysis tube ovary (OTHER 58740) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/58740?code_type=OTHER. Accessed .
Chicago (notes-bibliography)
“Adhesiolysis tube ovary (OTHER 58740) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/58740?code_type=OTHER.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $671–$9,838 (25th–75th percentile) across 149 hospitals · 378 payers.
“Negotiated” is the hospital’s negotiated facility rate for this OTHER 58740 — 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 |
|---|---|---|---|---|---|---|---|
| VIRGINIA MASON MEDICAL CENTER Outpatient | Confluence Health | Medicare Advantage | $8.08 | — | — | 2026-05-27 | MRF ↗ |
| VIRGINIA MASON MEDICAL CENTER Outpatient | Aetna | Medicare Advantage | $18.46 | — | — | 2026-05-27 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Arkansas Total Care | Medicaid | $19.04 | — | — | 2026-05-09 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Caresource | Medicaid | $19.80 | — | — | 2026-05-09 | MRF ↗ |
| VIRGINIA MASON MEDICAL CENTER Outpatient | First Choice | Commercial | $26.55 | — | — | 2026-05-27 | MRF ↗ |
| VIRGINIA MASON MEDICAL CENTER Outpatient | Aetna | Medicare Advantage Hmo | $39.46 | — | — | 2026-05-27 | MRF ↗ |
| VIRGINIA MASON MEDICAL CENTER Outpatient | Aetna | Medicare Advantage Ppo | $50.81 | — | — | 2026-05-27 | MRF ↗ |
| CROUSE HOSPITAL Outpatient | United Health | Essential Plans 1 -4 | $57.52 | $445.75 | $445.75 | 2026-05-13 | MRF ↗ |
| CROUSE HOSPITAL Outpatient | United Health | Essential Plans 1 -4 | $57.52 | $445.75 | $445.75 | 2026-05-22 | MRF ↗ |
| CROUSE HOSPITAL Outpatient | United Health | Medicaid | $57.52 | $445.75 | $445.75 | 2026-05-13 | MRF ↗ |
| CROUSE HOSPITAL Outpatient | United Health | Medicaid | $57.52 | $445.75 | $445.75 | 2026-05-22 | MRF ↗ |
| GRADY MEMORIAL HOSPITAL Outpatient | Caresource | Commercial | $58.17 | — | — | 2026-05-07 | MRF ↗ |
| JASPER MEMORIAL HOSPITAL Outpatient | Caresource | Commercial | $58.17 | — | — | 2026-05-06 | MRF ↗ |
| JASPER MEMORIAL HOSPITAL Outpatient | Peach State | Medicaid | $58.17 | — | — | 2026-05-06 | MRF ↗ |
| JASPER MEMORIAL HOSPITAL Outpatient | Amerigroup | Medicaid | $58.17 | — | — | 2026-05-06 | MRF ↗ |
| GRADY MEMORIAL HOSPITAL Outpatient | Amerigroup | Medicaid | $58.17 | — | — | 2026-05-07 | MRF ↗ |
| GRADY MEMORIAL HOSPITAL Outpatient | Peach State | Medicaid | $58.17 | — | — | 2026-05-07 | MRF ↗ |
| JASPER MEMORIAL HOSPITAL Outpatient | Caresource | Commercial | $58.17 | — | — | 2026-05-06 | MRF ↗ |
| GRADY MEMORIAL HOSPITAL Outpatient | Caresource | Commercial | $58.17 | — | — | 2026-05-07 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Health Alliance | Commercial | $85.43 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Health Alliance | Commercial | $85.43 | — | — | 2026-05-14 | MRF ↗ |
| CROUSE HOSPITAL Outpatient | Excellus | Govt Programs/ Special Products | $87.71 | $445.75 | $445.75 | 2026-05-22 | MRF ↗ |
| CROUSE HOSPITAL Outpatient | Excellus | Govt Programs/ Special Products | $87.71 | $445.75 | $445.75 | 2026-05-13 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Arkansas Total Care | Medicaid | $88.06 | — | — | 2026-05-09 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Caresource | Medicaid | $91.58 | — | — | 2026-05-09 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Arkansas Total Care | Medicaid | $95.04 | — | — | 2026-05-09 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Caresource | Medicaid | $98.84 | — | — | 2026-05-09 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Aetna | Coventry | $116.50 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Aetna | Coventry | $116.50 | — | — | 2026-05-14 | MRF ↗ |
| CROUSE HOSPITAL Outpatient | Aetna | Commercial | $116.94 | $445.75 | $445.75 | 2026-05-22 | MRF ↗ |
| CROUSE HOSPITAL Outpatient | Aetna | Commercial | $116.94 | $445.75 | $445.75 | 2026-05-13 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Upmc | Commercial | $126.75 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Upmc | Commercial | $126.75 | — | — | 2026-05-23 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Humana Choicecare | Medicare | $127.38 | — | — | 2026-05-09 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Complete Blue Mcr Adv | $128.38 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Community Blue Mcr Adv | $128.38 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Complete Blue Mcr Adv | $128.38 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Community Blue Mcr Adv | $128.38 | — | — | 2026-05-14 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Humana | Medicare Advantage | $128.65 | — | — | 2026-05-06 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Cigna | Commercial | $128.65 | — | — | 2026-05-06 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Viva | Commercial | $128.65 | — | — | 2026-05-06 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Viva | Medicare Advantage | $128.65 | — | — | 2026-05-06 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Simpra | Medicare Advantage | $128.65 | — | — | 2026-05-06 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Blue Cross | Medicare Advantage | $128.65 | — | — | 2026-05-06 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Aetna | Commercial | $128.65 | — | — | 2026-05-06 | MRF ↗ |
| PENOBSCOT VALLEY HOSPITAL Both | Medicare B Me Jk | Default | $129.28 | $715.23 | $572.18 | 2026-05-09 | MRF ↗ |
| PENN HIGHLANDS CONNELLSVILLE Outpatient | Blue Cross | Freedom Blue Mcr Adv | $129.75 | — | — | 2026-05-09 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Freedom Blue Mcr Adv | $129.75 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Freedom Blue Mcr Adv | $129.75 | — | — | 2026-05-14 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Simpra | Medicare Advantage | $129.83 | — | — | 2026-05-13 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Humana | Medicare Advantage | $129.83 | — | — | 2026-05-13 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Viva | Medicare Advantage | $129.83 | — | — | 2026-05-23 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Humana | Medicare Advantage | $129.83 | — | — | 2026-05-23 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Simpra | Medicare Advantage | $129.83 | — | — | 2026-05-23 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Viva | Medicare Advantage | $129.83 | — | — | 2026-05-13 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Bcbs | Medicare | $129.93 | — | — | 2026-05-09 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Ambetter | Commercial | $129.93 | — | — | 2026-05-09 | MRF ↗ |
| PENOBSCOT VALLEY HOSPITAL Both | Wellcare Health Plan Inc Mcr Adv | Default | $130.58 | $715.23 | $572.18 | 2026-05-09 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | United Healthcare | Commercial | $131.73 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | United Healthcare | Commercial | $131.73 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Hfn | Commercial | $131.73 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Hfn | Commercial | $131.73 | — | — | 2026-05-24 | MRF ↗ |
| PENN HIGHLANDS CONNELLSVILLE Outpatient | Blue Cross | Complete Blue Mcr Adv | $131.80 | — | — | 2026-05-09 | MRF ↗ |
| PENN HIGHLANDS CONNELLSVILLE Outpatient | Blue Cross | Community Blue Mcr Adv | $131.80 | — | — | 2026-05-09 | MRF ↗ |
| PENN HIGHLANDS CONNELLSVILLE Outpatient | Blue Cross | Community Blue Mcr Adv | $131.80 | — | — | 2026-05-09 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Cigna Healthspring | Medicare | $133.75 | — | — | 2026-05-09 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Windsor | Medicare | $133.75 | — | — | 2026-05-09 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Wellcare | Medicare | $133.75 | — | — | 2026-05-09 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Indemnity | $136.58 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Managed Care | $136.58 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Traditional Medicare | Traditional Medicare | $136.58 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Performance Blue | $136.58 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Aca | $136.58 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Performance Blue | $136.58 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Managed Care | $136.58 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Traditional Medicare | Traditional Medicare | $136.58 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS CONNELLSVILLE Outpatient | Geisinger | Mcr Advantage | $136.58 | — | — | 2026-05-09 | MRF ↗ |
| PENN HIGHLANDS CONNELLSVILLE Outpatient | Traditional Medicare | Traditional Medicare | $136.58 | — | — | 2026-05-09 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - All Social Mission | $136.58 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - My Blue Access Ppo | $136.58 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - My Blue Access Ppo | $136.58 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Aca | $136.58 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - All Social Mission | $136.58 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Indemnity | $136.58 | — | — | 2026-05-14 | MRF ↗ |
| FISHER-TITUS HOSPITAL Outpatient | Perennial Advantage | Perennial Advantage | $137.33 | — | — | 2026-05-27 | MRF ↗ |
| FISHER-TITUS HOSPITAL Outpatient | Optum | Vaccnoptum | $137.33 | — | — | 2026-05-27 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Upmc | Mcr Advantage | $139.31 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Upmc | Hmo Epo | $139.31 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Upmc | Mcr Advantage | $139.31 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Upmc | Hmo Epo | $139.31 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Geisinger | Mcr Advantage | $140.67 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Uhc | Mcr Advantage | $140.67 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Humana | Mcr Advantage | $140.67 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS CONNELLSVILLE Outpatient | Uhc | Mcr Advantage | $140.67 | — | — | 2026-05-09 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Humana | Mcr Advantage | $140.67 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Geisinger | Mcr Advantage | $140.67 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Uhc | Mcr Advantage | $140.67 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Uhc | Mcr Advantage | $140.67 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Uhc | Mcr Advantage | $140.67 | — | — | 2026-05-23 | MRF ↗ |
| FISHER-TITUS HOSPITAL Outpatient | Sidecar | Sidecarcommercial | $140.82 | — | — | 2026-05-27 | MRF ↗ |
| INTERMOUNTAIN HEALTH SPANISH FORK HOSPITAL Outpatient | Selecthealth | Medicare Advantage | $141.06 | — | — | 2026-05-15 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | American Health | Medicare Adv Ut Hmo I-Snp | $141.06 | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH SPANISH FORK HOSPITAL Outpatient | Selecthealth | Signature Individual Aca | $141.06 | — | — | 2026-05-15 | MRF ↗ |
| CABELL HUNTINGTON HOSPITAL, INC Outpatient | Peak Health | Medicare | $141.06 | — | — | 2026-05-14 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Aetna | Medicare Adv Hmo | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SPANISH FORK HOSPITAL Outpatient | Selecthealth | Medicaid | $141.06 | — | — | 2026-05-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH SPANISH FORK HOSPITAL Outpatient | Selecthealth | Value Individual Aca | $141.06 | — | — | 2026-05-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH SPANISH FORK HOSPITAL Outpatient | Aetna | Medicare Adv Hmo | $141.06 | — | — | 2026-05-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | American Health | Medicare Adv Ut Hmo I-Snp | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SPANISH FORK HOSPITAL Outpatient | Aetna | Medicare Adv Ppo | $141.06 | — | — | 2026-05-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Selecthealth | Medicaid | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Healthy U | Medicaid | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| CABELL HUNTINGTON HOSPITAL, INC Outpatient | Highmark Blue Cross | Medicare | $141.06 | — | — | 2026-05-14 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Molina | Medicare Complete Care Hmo Snp | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Humana | Medicare Choice Ppo | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Aetna | Medicare Adv Ppo | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Molina | Medicare Complete Care Hmo Snp | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | American Health | Medicare Adv Ut Hmo I-Snp | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Selecthealth | Medicare Advantage | $141.06 | — | — | 2026-05-14 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Molina | Medicare Choice Care Hmo | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Regence Bcbs | Medadvantage Ppo | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Health Choice | Medicaid | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Health Plan Of Nevada | Medicaid | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Selecthealth | Medicaid | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Selecthealth | Med Individual Aca | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Selecthealth | Medicaid | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SPANISH FORK HOSPITAL Outpatient | American Health | Medicare Adv Ut Hmo I-Snp | $141.06 | — | — | 2026-05-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH SPANISH FORK HOSPITAL Outpatient | Selecthealth | Med Individual Aca | $141.06 | — | — | 2026-05-15 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Uhc | Medicare Advantage | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Humana | Medicare Choice Ppo | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Molina | Medicare Choice Care Hmo | $141.06 | — | — | 2026-05-14 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Molina | Medicaid | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Health Partners Of Nevada | Medicare Advantage | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Humana | Medicare Choice Ppo | $141.06 | — | — | 2026-05-14 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Regence Bcbs | Medadvantage Ppo | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Health Plan Of Nevada | Medicaid | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Selecthealth | Medicare Advantage | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Molina | Medicaid | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Uhc | Medicare Advantage | $141.06 | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH SPANISH FORK HOSPITAL Outpatient | Molina | Medicare Advantage | $141.06 | — | — | 2026-05-15 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Regence Bcbs | Medadvantage | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Humana | Medicare Choice Ppo | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| CABELL HUNTINGTON HOSPITAL, INC Outpatient | Peak Health | Medicare | $141.06 | — | — | 2026-05-14 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Molina | Medicare Complete Care Hmo Snp | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Molina | Medicare Choice Care Hmo | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Molina | Medicare Complete Care Hmo Snp | $141.06 | — | — | 2026-05-14 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Selecthealth | Medicare Advantage | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Selecthealth | Medicaid | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | American Health | Medicare Adv Ut Hmo I-Snp | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Aetna | Medicare Adv Ppo | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Molina | Medicaid | $141.06 | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH SPANISH FORK HOSPITAL Outpatient | Uhc | Medicare Advantage | $141.06 | — | — | 2026-05-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH SPANISH FORK HOSPITAL Outpatient | Health Plan Of Nevada | Medicaid | $141.06 | — | — | 2026-05-15 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Uhc | Medicare Advantage | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Aetna | Medicare Adv Hmo | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Selecthealth | Medicare Advantage | $141.06 | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Health Plan Of Nevada | Medicaid | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | American Health | Medicare Adv Ut Hmo I-Snp | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Selecthealth | Medicaid | $141.06 | — | — | 2026-05-14 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Aetna | Medicare Adv Ppo | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | American Health | Medicare Adv Ut Hmo I-Snp | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Selecthealth | Signature Individual Aca | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Aetna | Medicare Adv Hmo | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Health Plan Of Nevada | Medicaid | $141.06 | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | American Health | Medicare Adv Ut Hmo I-Snp | $141.06 | — | — | 2026-05-14 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Aetna | Medicare Adv Hmo | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Regence Bcbs | Medadvantage Ppo | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Health Partners Of Nevada | Medicare Advantage | $141.06 | — | — | 2026-05-14 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Aetna | Medicare Adv Ppo | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Healthy U | Medicaid | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Healthy U | Medicaid | $141.06 | — | — | 2026-05-14 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Southwest Behavioral Health | Behavioral Health | $141.06 | — | — | 2026-05-13 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Molina | Medicare Complete Care Hmo Snp | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Uhc | Medicare Advantage | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Molina | Medicare Advantage | $141.06 | — | — | 2026-05-13 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Uhc | Medicare Advantage | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Molina | Medicare Complete Care Hmo Snp | $141.06 | — | — | 2026-05-13 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Molina | Medicaid | $141.06 | — | — | 2026-05-13 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Humana | Medicare Choice Ppo | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Regence Bcbs | Medadvantage Ppo | $141.06 | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Aetna | Medicare Adv Ppo | $141.06 | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Aetna | Medicare Adv Ppo | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Health Partners Of Nevada | Medicare Advantage | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Aetna | Medicare Adv Hmo | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Molina | Medicare Complete Care Hmo Snp | $141.06 | — | — | 2026-05-14 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Molina | Medicaid | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Molina | Medicare Choice Care Hmo | $141.06 | — | — | 2026-05-13 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Regence Bcbs | Medadvantage Ppo | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Humana | Medicare Choice Ppo | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Uhc | Medicare Advantage | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Healthy U | Medicaid | $141.06 | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Molina | Medicaid | $141.06 | — | — | 2026-05-14 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Molina | Medicare Choice Care Hmo | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Uhc | Medicare Advantage | $141.06 | — | — | 2026-05-13 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Selecthealth | Medicare Advantage | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Health Partners Of Nevada | Medicare Advantage | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Regence Bcbs | Medadvantage Ppo | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Health Plan Of Nevada | Medicaid | $141.06 | — | — | 2026-05-09 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | American Health | Medicare Adv Ut Hmo I-Snp | $141.06 | — | — | 2026-05-13 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Molina | Medicaid | $141.06 | — | — | 2026-05-09 | 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.