600121 — IV Infusion Hydrate Ea Addl Hr
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). IV INFUSION HYDRATE EA ADDL HR (CDM 600121) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/600121?code_type=CDM
MLA (9th ed.)
“IV INFUSION HYDRATE EA ADDL HR (CDM 600121) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/600121?code_type=CDM. Accessed .
Chicago (notes-bibliography)
“IV INFUSION HYDRATE EA ADDL HR (CDM 600121) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/600121?code_type=CDM.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $10–$62 (25th–75th percentile) across 4 hospitals · 106 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CDM 600121 — 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 |
|---|---|---|---|---|---|---|---|
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Superior Health Plan | STARKids | $0.15 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Superior Health Plan | CHIP | $0.15 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Superior Health Plan | STARPLUS | $0.15 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Superior Health Plan | CHPFC | $0.15 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Superior Health Plan | STAR | $0.15 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Community Health Choice MCD | CHIP | $0.34 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Community Health Choice MCD | STAR | $0.34 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Community Health Choice MCD | STAR+PLUS | $0.34 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Community Health Choice MCD | CHIPPerinatal | $0.34 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Amerigroup | MCDCHIPBH | $0.36 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Amerigroup | MGMCD | $0.36 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | BCBS | MyBlueHealth | $0.42 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Superior | EPO | $0.45 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Superior | HMO | $0.45 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | BCBS | BAV | $0.46 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Oscar | HIX | $0.50 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Cigna | CSN | $0.51 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Superior | ValueHMO | $0.51 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Cigna | OpenAccessPlus | $0.54 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | BCBS | HMO | $0.58 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | BCBS | EPOSOA | $0.59 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | BCBS | PPO | $0.60 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Texas Childrens Health Plans | STARKIDS | $0.61 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Texas Childrens Health Plans | STAR | $0.61 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Aetna | QHPExchange | $0.63 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | United | OptionsPPO | $0.63 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Cigna | PPO | $0.65 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Healthcare Highways | NarrowNetwork | $0.66 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Texas Childrens Health Plans | CHIP | $0.67 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Molina Healthcare | HIX | $0.70 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Evry Health | BroadNetwork | $0.70 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Humana | HMO | $0.82 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Humana | PPO | $0.82 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Imagine Health | PPO | $0.90 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Kelsey Care (Boon-Chapman) | COMM | $0.90 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | BCBS | Traditional | $0.90 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Aetna | COMM | $0.99 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Christus (USFHP) | TRICARE | $1.03 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Curative Administrators | COMM | $1.03 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | HealthSmart Preferred Care | ACCEL | $1.11 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Aetna | ASA | $1.15 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Fidelis SecureCare of TX | MGMCR | $1.16 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | United | GlobalAppendix | $1.16 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Averde Health | Commercial | $1.16 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Aetna | OON | $1.17 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Multiplan | SAVILITYNETWORK | $1.29 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Coventry National First Health | COMM | $1.38 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Rockport Workers Comp | COMM | $1.42 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Physicians Cooperative of Texas | WC | $1.42 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | SouthWest Medical | WORKERSCOMP | $1.55 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Beech Street | WCOMP | $1.55 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Independent Medical System | COMM | $1.55 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | National Healthcare Solutions | COMM | $1.55 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Coastal Comp | COMM | $1.68 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Affiliated PPO | COMM | $1.94 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Fiesta Mart, Inc | COMM | $1.94 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Beech Street | COMMPPO | $2.06 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | HealthSmart Preferred Care | PPO | $2.12 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Physicians, INC | COMM | $2.19 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | HealthSmart Preferred Care | ACCOUNTABLEPPO | $2.19 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Multiplan | COMPLEMENTARYPPO | $2.32 | $2.58 | $2.58 | 2026-03-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | WELLPOINT CHIP/CHIP PERINATE | 4163_AMERIGROUP CHIP/STAR KIDS (SMV) OUTPATIENT 20241201 | $6.75 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | BCBS CHIP/CHIP PERINATE | 4174_BLUE CROSS CHIP/STAR KIDS (SMV) OUTPATIENT 20241201 | $6.75 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | BCBS STAR KIDS | 5015_BLUE CROSS STAR KIDS (SMV) OUTPATIENT 20241201 | $6.75 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | WELLPOINT STAR | 4203_CHIRP WELLPOINT/AMERIGROUP STAR (SMV) OUTPATIENT 20241201 | $6.75 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | BCBS CHIP/CHIP PERINATE | 4174_BLUE CROSS CHIP (SMV) OUTPATIENT 20241201 | $6.75 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | UHC STAR KIDS | 4317_UHC STAR KIDS (SMV) OUTPATIENT 20241201 | $6.75 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | WELLPOINT STAR | 4203_CHIRP AMERIGROUP STAR (SMV) OUTPATIENT 20241201 | $6.75 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | BCBS STAR | 4225_CHIRP BLUE CROSS STAR (SMV) OUTPATIENT 20241201 | $6.75 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | WELLPOINT STAR PLUS | 4214_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (SMV) OUTPATIENT 20241201 | $6.75 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | WELLPOINT STAR KIDS | 4982_WELLPOINT/AMERIGROUP STAR KIDS (SMV) OUTPATIENT 20241201 | $6.75 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | UHC STAR PLUS | 4270_CHIRP UHC STAR PLUS (SMV) OUTPATIENT 20241201 | $6.75 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | DELL STAR | 4236_CHIRP DELL STAR (SMV) OUTPATIENT 20241201 | $6.75 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | DELL CHIP/CHIP PERINATE | 4185_DELL CHIP/STAR KIDS (SMV) OUTPATIENT 20241201 | $6.75 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | UHC STAR | 4259_CHIRP UHC STAR (SMV) OUTPATIENT 20241201 | $6.75 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | WELLPOINT CHIP/CHIP PERINATE | 4163_WELLPOINT/AMERIGROUP CHIP (SMV) OUTPATIENT 20241201 | $6.75 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | WELLPOINT STAR PLUS | 4214_CHIRP AMERIGROUP STAR PLUS (SMV) OUTPATIENT 20241201 | $6.75 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | SENDERO CHAP | 4934_SENDERO CHAP 20250811 | $7.50 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | ASCENSION COMPLETE MEDICARE REPLACEMENT | 4752_MEDICARE ADVANTAGE ASCENSION COMPLETE SMV 20250811 | $8.25 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | HUMANA MCR REPLACEMENT | 4663_MEDICARE ADVANTAGE HUMANA (SMV) 20250811 | $8.25 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Both | UHC STAR PLUS | 3754_CHIRP UHC STAR PLUS (SMV) INPATIENT 20240901 | $8.25 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | UHC MCR REPLACEMENT | 4689_MEDICARE ADVANTAGE UNITED HEALTHCARE (SMV) 20250811 | $8.25 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | ADDR CANCER TOGETHER | 4746_ADDR CANCER TOGETHER SMV 20250811 | $8.25 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Both | WELLPOINT STAR | 3677_CHIRP WELLPOINT/AMERIGROUP STAR (SMV) INPATIENT 20240901 | $8.25 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | WELMED MEDICARE | 4670_MEDICARE ADVANTAGE WELMED (SMV) 20250811 | $8.25 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Both | BCBS CHIP/CHIP PERINATE | 3600_BLUE CROSS CHIP/STAR KIDS (SMV) INPATIENT 20240901 | $8.25 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | CONNECTED SENIOR CARE | 4917_MEDICARE ADVANTAGE CONNECTED SENIOR CARE (SMV) 20250811 | $8.25 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | WILLIAMSON/HAYS COUNTY INDIGNENT (NW) 20140101 | 616_WILLIAMSON/HAYS COUNTY INDIGNENT (NW) 20140101 | $8.25 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Both | BCBS STAR | 3699_CHIRP BLUE CROSS STAR (SMV) INPATIENT 20240901 | $8.25 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Inpatient | DEVOTED HEALTH MCR REPLACEMENT | 4920_MEDICARE ADVANTAGE DEVOTED HEALTH SMV 20250811 | $8.25 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Inpatient | MEDICARE OON | 4667_MEDICARE ADVANTAGE OON (SMV) 20250811 | $8.25 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Both | UHC STAR | 3743_CHIRP UHC STAR (SMV) INPATIENT 20240901 | $8.25 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | AARP MC WELLMED | 4657_MEDICARE ADVANTAGE AARP WELLMED SMV 20250811 | $8.25 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Both | WELLPOINT CHIP/CHIP PERINATE | 3589_WELLPOINT CHIP/STAR KIDS (SMV) INPATIENT 20240901 | $8.25 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Both | UHC STAR KIDS | 4328_UHC STAR KIDS (SMV) INPATIENT 20240901 | $8.25 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | AETNA MCR REPLACEMENT | 4658_MEDICARE ADVANTAGE AETNA (SMV) 20250811 | $8.25 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Inpatient | MEDICARE REPLACEMENT | 4924_MEDICARE ADVANTAGE SMV 20250811 | $8.25 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Both | DELL CHIP/CHIP PERINATE | 3611_DELL CHIP/STAR KIDS (SMV) INPATIENT 20240901 | $8.25 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | TRICARE | 4964_TRICARE SMV 20280811 | $8.25 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Both | DELL STAR | 3710_CHIRP DELL STAR (SMV) INPATIENT 20240901 | $8.25 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | SUPERIOR ALLWELL | 4685_MEDICARE ADVANTAGE SUPERIOR ALLWELL (SMV) 20250811 | $8.25 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Both | WELLPOINT STAR PLUS | 3688_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (SMV) INPATIENT 20240901 | $8.25 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | SMARTHEALTH | 4959_SMARTHEALTH SMV 20280811 | $8.25 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Outpatient | WILLIAMSON/HAYS COUNTY INDIGNENT (NW) 20140101 | 616_WILLIAMSON/HAYS COUNTY INDIGNENT (NW) 20140101 | $8.25 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | WELLCARE MED ADVANTAGE | 4690_MEDICARE ADVANTAGE WELLCARE (SMV) 20250811 | $8.25 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | PPHP MCR ADVANTAGE | 4927_MEDICARE ADVANTAGE PPHP SMV 20250811 | $9.00 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | WILLIAMSON/HAYS COUNTY INDIGNENT (SW) 20140101 | 618_WILLIAMSON/HAYS COUNTY INDIGNENT (SW) 20140101 | $9.00 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | TX INDEPENDENCE HP | 4744_TX INDEPENDENCE HP 20250811 | $9.00 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | TRAVIS COUNTY INDIGENT | 4141_TRAVIS COUNTY INDIGENT (SMV) 20240901 | $9.00 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Outpatient | WILLIAMSON/HAYS COUNTY INDIGNENT (SW) 20140101 | 618_WILLIAMSON/HAYS COUNTY INDIGNENT (SW) 20140101 | $9.00 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Outpatient | DELL STAR | 4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201 | $10.50 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Both | UHC STAR | 3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901 | $10.50 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Both | DELL STAR | 3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901 | $10.50 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Outpatient | UHC STAR KIDS | 4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | $10.50 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Both | UHC STAR PLUS | 3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901 | $10.50 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Outpatient | UHC STAR PLUS | 4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | $10.50 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Outpatient | UHC STAR | 4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201 | $10.50 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Both | BCBS CHIP/CHIP PERINATE | 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901 | $10.50 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Outpatient | COUNTY INDIGENT | 501_COUNTY INDIGENT (BRK,DEL,SMV,BAS) 20140601 | $10.50 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Both | SUPERIOR AMBETTER | 3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901 | $10.50 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Outpatient | SUPERIOR AMBETTER | 3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901 | $10.50 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Both | WELLPOINT STAR | 3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901 | $10.50 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Both | WELLPOINT STAR | 4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201 | $10.50 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Both | UHC STAR KIDS | 4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901 | $10.50 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Both | WELLPOINT STAR | 4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201 | $10.50 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Outpatient | WELLPOINT STAR PLUS | 4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | $10.50 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Both | WELLPOINT STAR PLUS | 4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | $10.50 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Outpatient | WELLPOINT CHIP/CHIP PERINATE | 4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201 | $10.50 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Both | WELLPOINT STAR | 3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901 | $10.50 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Both | WELLPOINT CHIP/CHIP PERINATE | 4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | $10.50 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Both | BCBS STAR | 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901 | $10.50 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | WELLPOINT CHIP/CHIP PERINATE | 4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201 | $10.50 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Both | UHC STAR | 3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901 | $10.50 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | UHC STAR KIDS | 4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | $10.50 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Both | BCBS STAR | 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901 | $10.50 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Both | UHC STAR KIDS | 4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901 | $10.50 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | UHC STAR | 4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201 | $10.50 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | MDSAVE | 4915_MDSAVE SMV 20250811 | $10.50 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | UHC STAR PLUS | 4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | $10.50 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Outpatient | BCBS CHIP/CHIP PERINATE | 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201 | $10.50 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | SUPERIOR AMBETTER | 3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901 | $10.50 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Outpatient | BCBS CHIP/CHIP PERINATE | 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | $10.50 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Both | UHC STAR PLUS | 3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901 | $10.50 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Both | WELLPOINT STAR | 4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201 | $10.50 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | COUNTY INDIGENT | 501_COUNTY INDIGENT (BRK,DEL,SMV,BAS) 20140601 | $10.50 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Outpatient | BCBS STAR KIDS | 5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | $10.50 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Both | SUPERIOR AMBETTER | 3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901 | $10.50 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Both | WELLPOINT STAR PLUS | 3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901 | $10.50 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Outpatient | WELLPOINT STAR KIDS | 4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | $10.50 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | WELLPOINT STAR KIDS | 4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | $10.50 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Both | DELL CHIP/CHIP PERINATE | 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901 | $10.50 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Both | WELLPOINT CHIP/CHIP PERINATE | 4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | $10.50 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Both | DELL CHIP/CHIP PERINATE | 4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | $10.50 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Both | WELLPOINT STAR | 4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201 | $10.50 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Both | WELLPOINT STAR PLUS | 3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901 | $10.50 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | WELLPOINT STAR PLUS | 4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | $10.50 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Both | WELLPOINT STAR PLUS | 4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | $10.50 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | DELL STAR | 4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201 | $10.50 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Both | DELL CHIP/CHIP PERINATE | 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901 | $10.50 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Both | BCBS CHIP/CHIP PERINATE | 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901 | $10.50 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Both | DELL STAR | 3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901 | $10.50 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Both | DELL CHIP/CHIP PERINATE | 4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | $10.50 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | BCBS STAR KIDS | 5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | $10.50 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | BCBS CHIP/CHIP PERINATE | 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201 | $10.50 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | BCBS CHIP/CHIP PERINATE | 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | $10.50 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | SMARTHEALTH | 4680_SMARTHEALTH IP 20251001 | $14.25 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | SMARTHEALTH | 4957_SMARTHEALTH OP 20250811 | $14.25 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Outpatient | SMARTHEALTH | 4957_SMARTHEALTH OP 20250811 | $14.25 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Outpatient | SMARTHEALTH | 4680_SMARTHEALTH IP 20251001 | $14.25 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Both | BCBS STAR | 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201 | $15.00 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | COUNTY INDIGENT | 502_COUNTY INDIGENT (CHI,DCN) 20140701 | $15.00 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | TRAVIS COUNTY INDIGENT | 4139_TRAVIS COUNTY INDIGENT (CHI,DCN) 20240901 | $15.00 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Both | BCBS STAR | 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201 | $15.00 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Outpatient | TRAVIS COUNTY INDIGENT | 4139_TRAVIS COUNTY INDIGENT (CHI,DCN) 20240901 | $15.00 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Outpatient | COUNTY INDIGENT | 502_COUNTY INDIGENT (CHI,DCN) 20140701 | $15.00 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | WINGS | 902_WINGS | $16.50 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Outpatient | WINGS | 902_WINGS | $16.50 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | TEXAS REHAB | 603_TEXAS REHAB VOCATIONAL | $17.25 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Both | UTMB | 530_UTMB PRISONS (CHI,DCN) 20140101 | $17.25 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Outpatient | TEXAS REHAB | 603_TEXAS REHAB VOCATIONAL | $17.25 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Both | UTMB | 530_UTMB PRISONS (CHI,DCN) 20140101 | $17.25 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | TX REHAB | 510_TEXAS REHAB (AUS,NW,SW) 20150101 | $20.25 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Outpatient | TX REHAB | 510_TEXAS REHAB (AUS,NW,SW) 20150101 | $20.25 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | CORNERSTONE | 602_CORNERSTONE HOSPITAL | $22.50 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Outpatient | CORNERSTONE | 602_CORNERSTONE HOSPITAL | $22.50 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | CSHCN CIDC | 4694_CSHCN CIDC IP (ADULT) 20251001 | $24.00 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Both | MEDICARE OON | 4666_MEDICARE ADVANTAGE INPATIENT OON 20251001 | $24.00 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | WHOLE FOODS | 4512_WHOLE FOODS 20251001 | $24.00 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Both | MEDICARE OON | 4666_MEDICARE ADVANTAGE INPATIENT OON 20251001 | $24.00 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Outpatient | WHOLE FOODS | 4512_WHOLE FOODS 20251001 | $24.00 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Outpatient | CSHCN CIDC | 4694_CSHCN CIDC IP (ADULT) 20251001 | $24.00 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | BCBS BAV EXCHANGE | 4093_BLUE CROSS BLUE SHIELD BAV EXCHANGE (CHI,DCN) 20250101 | $25.50 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | SENDERO IDEALCARE | 816_SENDERO IDEALCARE CHAP (CHI,DCN) 20180301 | $25.50 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Outpatient | BCBS BAV EXCHANGE | 4093_BLUE CROSS BLUE SHIELD BAV EXCHANGE (CHI,DCN) 20250101 | $25.50 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Outpatient | SENDERO IDEALCARE | 816_SENDERO IDEALCARE CHAP (CHI,DCN) 20180301 | $25.50 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | VISTA HEALTH | 594_VISTA 360 (CHI,DCN) HEALTHPLAN | $26.25 | $75.00 | $27.00 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Outpatient | VISTA HEALTH | 594_VISTA 360 (CHI,DCN) HEALTHPLAN | $26.25 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Outpatient | FIRST CARE PROVIDENCE EMPLOYEE | 204_FIRST CARE PROVIDENCE EMPLOYEE 20101001 | $30.00 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Both | SUPERIOR STAR | 3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901 | $30.00 | $75.00 | $52.50 | 2026-01-01 | MRF ↗ |
| DELL CHILDREN'S MEDICAL CENTER Outpatient | SUPERIOR STAR KIDS | 4889_SUPERIOR STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | $30.00 | $75.00 | $52.50 | 2026-01-01 | 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.