6074 — Scr Syn Canc Mini Ti Full Th 4.0 X 16
Cite this view
HANK Price Transparency. (n.d.). SCR SYN CANC MINI TI FULL TH 4.0 X 16 (CPT 6074) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/6074?code_type=CPT
“SCR SYN CANC MINI TI FULL TH 4.0 X 16 (CPT 6074) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/6074?code_type=CPT. Accessed .
“SCR SYN CANC MINI TI FULL TH 4.0 X 16 (CPT 6074) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/6074?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $61–$50,609 (25th–75th percentile) across 10 hospitals · 45 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT 6074 — 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 |
|---|---|---|---|---|---|---|---|
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Health Options Inc | Bcbs Health Options Medicare | $15.52 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Blue Cross Blue Shield Of Florida | Bcbs Medicare Ppo | $15.52 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Careplus | Careplus | $19.61 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Aetna Health | Aetna Medicare | $24.51 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | Care Improvement Plus | Medicare Advantage | — | $332.56 | $279.35 | 2026-05-09 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | Encore | Ppo | — | $332.56 | $279.35 | 2026-05-09 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | Mdwise | Excel And Hoosier Healthwise | $31.20 | $332.56 | $279.35 | 2026-05-09 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | Managed Health Services | Medicaid | $31.20 | $332.56 | $279.35 | 2026-05-09 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | Anthem | Ppo Hmo Exchange | — | $332.56 | $279.35 | 2026-05-09 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | Coventry | Commercial | — | $332.56 | $279.35 | 2026-05-09 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | United Healthcare | Medicaid | $31.20 | $332.56 | $279.35 | 2026-05-09 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | Aetna | Medicare Advantage | — | $332.56 | $279.35 | 2026-05-09 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | Humana Healthnet | Tricare | — | $332.56 | $279.35 | 2026-05-09 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | Consumer Life | Commercial | — | $332.56 | $279.35 | 2026-05-09 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Msmc | Cigna | $34.31 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Humana | Humana Humx | $35.13 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Oscar Health (Hie) | Oscar Health (Hie) | $36.77 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Dimension Health | Dimension Plus | $36.77 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Aetna Health | Aetna Workers Comp | $38.40 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Health Options Inc | Bcbs Health Options Hmo | $44.94 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Blue Cross Blue Shield Of Florida | Bcbs Traditional | $44.94 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Blue Cross Blue Shield Of Florida | Bcbs Network Blue | $44.94 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Blue Cross Blue Shield Of Florida | Bcbs Ppo | $44.94 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Dimension Health | Dimension International | $49.02 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Corvel Healthcare | Corvel Healthcare | $49.39 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Aetna Health | Aetna | $53.10 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Workmans Compensation | Workmans Compensation | $53.11 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Care Management Network | Care Management Network | $53.11 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Corvel Healthcare | Corvel Healthcare | $56.99 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Beech Street | Beech Street | $57.19 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Dimension Health | Dimension | $57.19 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Behavioral Services Network | Behavioral Services Network | $57.19 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Cigna Behavioral Health | Cigna Behavioral Health | $57.19 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Coventry | Coventry | $58.01 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Workmans Compensation | Workmans Compensation | $61.27 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Multiplan | Multiplan | $61.28 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Blue Cross Blue Shield Of Florida | Bcbs Workers Compensation | $61.28 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Beech Street | Beech Street | $61.28 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Seasons Hospice | Seasons Hospice | $61.28 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Blue Cross Blue Shield Of Florida | Bcbs Workers Compensation | $65.36 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Aetna International Ppo | Aetna International Ppo | $69.45 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Wellcare | Wellcare | $69.45 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | First Health Network | First Health | $69.45 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Miscellaneous Insurances | Miscellaneous Insurances | $81.70 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Nch Devoted Medicare | Nch Devoted Medicare Rad Onc | $81.70 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Nch Devoted Medicare | Nch Devoted Medicare Rad Onc | $81.70 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Nch Devoted Medicare | Nch Devoted Medicare Med Onc | $81.70 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Concordia Behavioral Health | Concordia Behavioral Health | $81.70 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Nch Management Systems | Nch Careplus Medicare | $81.70 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Nch Management Systems | Nch Humana Medicare | $81.70 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Nch Management Systems | Nch Simply Medicare | $81.70 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | New Directions Behavioral Health | New Directions Behavioral Health | $81.70 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | University Of Miami Behavioral Health | University Of Miami Behavioral Health | $81.70 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Vitas Healthcare Of Fl | Vitas | $81.70 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Magellan Behavioral Health | Magellan Behavioral Health | $81.70 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Nch Management Systems | Nch Coventry Medicare | $81.70 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | United Healthcare | United Behavioral Medicaid | $81.70 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | United Healthcare | United Behavioral | $81.70 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | United Healthcare | United Behavioral Medicare | $81.70 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Tricare | Tricare | $81.70 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Mental Health Associates | Mental Health Associates | $81.70 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Cenpatico Behavioral Health | Cenpatico Behavioral Health | $81.70 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Blue Cross Blue Shield Of Florida | Bcbs Rehab Ppo | $81.70 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Humana Behavioral Health | Humana Behavioral Health Medicare | $81.70 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Humana Behavioral Health | Humana Behavioral Health | $81.70 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Value Options | Value Options Behavioral Health | $81.70 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Medicaid Hmo Apr Drg | Medicaid Hmo Apr Drg | $129.72 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Magellan Complete Care | Magellan Complete Care | $138.80 | $81.70 | $81.70 | 2026-05-22 | MRF ↗ |
| TEXAS HEALTH HOSPITAL FRISCO Inpatient | Parkland | Medicaid | $45,861.71 | — | — | 2026-05-24 | MRF ↗ |
| TEXAS HEALTH HOSPITAL FRISCO Inpatient | Superior | Bh | $45,861.71 | — | — | 2026-05-24 | MRF ↗ |
| TEXAS HEALTH HOSPITAL FRISCO Inpatient | Amerigroup | Medicaid | $45,861.71 | — | — | 2026-05-24 | MRF ↗ |
| TEXAS HEALTH HOSPITAL FRISCO Inpatient | Amerigroup | Medicaid | $45,861.71 | — | — | 2026-05-07 | MRF ↗ |
| TEXAS HEALTH HOSPITAL FRISCO Inpatient | Parkland | Medicaid | $45,861.71 | — | — | 2026-05-07 | MRF ↗ |
| TEXAS HEALTH HOSPITAL FRISCO Inpatient | Superior | Bh | $45,861.71 | — | — | 2026-05-07 | MRF ↗ |
| TEXAS HEALTH HARRIS METHODIST HOSPITAL ALLIANCE Inpatient | Amerigroup | Medicaid | $46,643.93 | — | — | 2026-05-08 | MRF ↗ |
| TEXAS HEALTH HARRIS METHODIST HOSPITAL ALLIANCE Inpatient | Superior | Bh | $46,643.93 | — | — | 2026-05-08 | MRF ↗ |
| TEXAS HEALTH HARRIS METHODIST HOSPITAL ALLIANCE Inpatient | Cook Childrens | Medicaid | $46,643.93 | — | — | 2026-05-08 | MRF ↗ |
| TEXAS HEALTH HARRIS METHODIST HOSPITAL ALLIANCE Inpatient | Cook Childrens | Medicaid | $46,643.93 | — | — | 2026-05-24 | MRF ↗ |
| TEXAS HEALTH HARRIS METHODIST HOSPITAL ALLIANCE Inpatient | Amerigroup | Medicaid | $46,643.93 | — | — | 2026-05-24 | MRF ↗ |
| TEXAS HEALTH HARRIS METHODIST HOSPITAL ALLIANCE Inpatient | Superior | Bh | $46,643.93 | — | — | 2026-05-24 | MRF ↗ |
| TEXAS HEALTH HOSPITAL FRISCO Inpatient | Molina | Medicaid | $49,530.65 | — | — | 2026-05-07 | MRF ↗ |
| TEXAS HEALTH HOSPITAL FRISCO Inpatient | Molina | Medicaid | $49,530.65 | — | — | 2026-05-24 | MRF ↗ |
| TEXAS HEALTH HARRIS METHODIST HOSPITAL ALLIANCE Inpatient | Molina | Medicaid | $50,375.44 | — | — | 2026-05-08 | MRF ↗ |
| TEXAS HEALTH HARRIS METHODIST HOSPITAL ALLIANCE Inpatient | Molina | Medicaid | $50,375.44 | — | — | 2026-05-24 | MRF ↗ |
| TEXAS HEALTH HARRIS METHODIST HOSPITAL ALLIANCE Inpatient | Aetna | Medicaid | $51,308.32 | — | — | 2026-05-08 | MRF ↗ |
| TEXAS HEALTH HARRIS METHODIST HOSPITAL ALLIANCE Inpatient | Aetna | Medicaid | $51,308.32 | — | — | 2026-05-24 | MRF ↗ |
| TEXAS HEALTH HOSPITAL FRISCO Inpatient | Superior | Medicaid | $62,830.54 | — | — | 2026-05-24 | MRF ↗ |
| TEXAS HEALTH HOSPITAL FRISCO Inpatient | Superior | Medicaid | $62,830.54 | — | — | 2026-05-07 | MRF ↗ |
| TEXAS HEALTH HARRIS METHODIST HOSPITAL ALLIANCE Inpatient | Superior | Medicaid | $63,902.18 | — | — | 2026-05-08 | MRF ↗ |
| TEXAS HEALTH HARRIS METHODIST HOSPITAL ALLIANCE Inpatient | Superior | Medicaid | $63,902.18 | — | — | 2026-05-24 | MRF ↗ |
| AVERA MCKENNAN HOSPITAL & UNIVERSITY HEALTH CENTER Inpatient | Bcbsmn Insurance | Min | $85,098.81 | — | — | 2026-05-23 | MRF ↗ |
| AVERA MCKENNAN HOSPITAL & UNIVERSITY HEALTH CENTER Inpatient | Bcbsmn Insurance | Min | $85,098.81 | — | — | 2026-05-13 | MRF ↗ |
| AVERA MARSHALL REGIONAL MEDICAL CTR Inpatient | Bcbsmn Insurance | Min | $90,603.69 | — | — | 2026-05-09 | MRF ↗ |
| AVERA HEART HOSPITAL OF SOUTH DAKOTA Inpatient | Bcbsmn Insurance | Min | $232,218.27 | — | — | 2026-05-13 | MRF ↗ |
| AVERA HEART HOSPITAL OF SOUTH DAKOTA Inpatient | Bcbsmn Insurance | Min | $232,218.27 | — | — | 2026-05-22 | MRF ↗ |
| AVERA ST MARY'S HOSPITAL Inpatient | Wellmark Insurance | Ppo | $279,319.72 | — | — | 2026-05-14 | MRF ↗ |
| AVERA ST MARY'S HOSPITAL Inpatient | Wellmark Insurance | Ppo | $279,319.72 | — | — | 2026-05-22 | MRF ↗ |
| AVERA HEART HOSPITAL OF SOUTH DAKOTA Inpatient | Wellmark Insurance | Hmo | $280,753.93 | — | — | 2026-05-13 | MRF ↗ |
| AVERA HEART HOSPITAL OF SOUTH DAKOTA Inpatient | Wellmark Insurance | Ppo | $280,753.93 | — | — | 2026-05-13 | MRF ↗ |
| AVERA HEART HOSPITAL OF SOUTH DAKOTA Inpatient | Wellmark Insurance | Hmo | $280,753.93 | — | — | 2026-05-22 | MRF ↗ |
| AVERA HEART HOSPITAL OF SOUTH DAKOTA Inpatient | Wellmark Insurance | Ppo | $280,753.93 | — | — | 2026-05-22 | MRF ↗ |
| AVERA MCKENNAN HOSPITAL & UNIVERSITY HEALTH CENTER Inpatient | Bcbsmn Insurance | Awa | $288,976.02 | — | — | 2026-05-13 | MRF ↗ |
| AVERA MCKENNAN HOSPITAL & UNIVERSITY HEALTH CENTER Inpatient | Bcbsmn Insurance | Awa | $288,976.02 | — | — | 2026-05-23 | MRF ↗ |
| AVERA MCKENNAN HOSPITAL & UNIVERSITY HEALTH CENTER Inpatient | Wellmark Insurance | Ppo | $293,895.25 | — | — | 2026-05-13 | MRF ↗ |
| AVERA MCKENNAN HOSPITAL & UNIVERSITY HEALTH CENTER Inpatient | Wellmark Insurance | Ppo | $293,895.25 | — | — | 2026-05-23 | MRF ↗ |
| AVERA MCKENNAN HOSPITAL & UNIVERSITY HEALTH CENTER Inpatient | Wellmark Insurance | Hmo | $293,895.25 | — | — | 2026-05-23 | MRF ↗ |
| AVERA MCKENNAN HOSPITAL & UNIVERSITY HEALTH CENTER Inpatient | Wellmark Insurance | Hmo | $293,895.25 | — | — | 2026-05-13 | MRF ↗ |
| AVERA HEART HOSPITAL OF SOUTH DAKOTA Inpatient | Bcbsmn Insurance | Awa | $311,812.20 | — | — | 2026-05-13 | MRF ↗ |
| AVERA HEART HOSPITAL OF SOUTH DAKOTA Inpatient | Bcbsmn Insurance | Awa | $311,812.20 | — | — | 2026-05-22 | MRF ↗ |
| AVERA MARSHALL REGIONAL MEDICAL CTR Inpatient | Bcbsmn Insurance | Awa | $333,801.48 | — | — | 2026-05-09 | MRF ↗ |
| AVERA QUEEN OF PEACE Inpatient | Wellmark Insurance | Ppo | $341,140.62 | — | — | 2026-05-09 | MRF ↗ |
| AVERA ST LUKES Inpatient | Wellmark Insurance | Ppo | $353,514.81 | — | — | 2026-05-09 | MRF ↗ |