61958110101 — Emtricita-rilpivirine-tenof Df 200-25-300 Mg Tab 30 Each Bottle
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). EMTRICITA-RILPIVIRINE-TENOF DF 200-25-300 MG TAB 30 EACH BOTTLE (NDC 61958110101) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/61958110101?code_type=NDC
MLA (9th ed.)
“EMTRICITA-RILPIVIRINE-TENOF DF 200-25-300 MG TAB 30 EACH BOTTLE (NDC 61958110101) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/61958110101?code_type=NDC. Accessed .
Chicago (notes-bibliography)
“EMTRICITA-RILPIVIRINE-TENOF DF 200-25-300 MG TAB 30 EACH BOTTLE (NDC 61958110101) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/61958110101?code_type=NDC.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $193–$580 (25th–75th percentile) across 75 hospitals · 282 payers.
“Negotiated” is the hospital’s negotiated facility rate for this NDC 61958110101 — 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 |
|---|---|---|---|---|---|---|---|
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | HAP | Self Insured | $2.10 | $363.82 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | HAP | Self Insured | $2.10 | $363.82 | — | 2025-06-28 | MRF ↗ |
| ST JUDE CHILDRENS RESEARCH HOSPITAL OutpatientFacility | Empower | MANAGED MEDICAID | $21.00 | $141.00 | — | 2025-07-01 | MRF ↗ |
| ST JUDE CHILDRENS RESEARCH HOSPITAL OutpatientFacility | HealthCare Connections LA | MANAGED MEDICAID | $21.50 | $141.00 | — | 2025-07-01 | MRF ↗ |
| RANDOLPH HOSPITAL Both | Medcost | Ultra | $21.84 | $109.20 | — | 2026-07-15 | MRF ↗ |
| KULA HOSPITAL Outpatient | Hmsa | Hmo | $22.73 | $378.81 | $148.00 | 2026-07-15 | MRF ↗ |
| KULA HOSPITAL Outpatient | Hmsa | Ppo | $22.73 | $378.81 | $148.00 | 2026-07-15 | MRF ↗ |
| ST JUDE CHILDRENS RESEARCH HOSPITAL OutpatientFacility | Healthy Blue | MANAGED MEDICAID | $35.25 | $141.00 | — | 2025-07-01 | MRF ↗ |
| RANDOLPH HOSPITAL Both | Cigna | Hmo & Ppo | $36.03 | $109.20 | — | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Inpatient | Aetna | Hmo | $40.86 | $585.75 | $585.75 | 2026-07-15 | MRF ↗ |
| KULA HOSPITAL Outpatient | Uhc | Quest | $60.00 | $378.81 | $148.00 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - REDWOOD CITY Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $401.05 | $224.59 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSP SO SACRAMENTO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $401.05 | $224.59 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL AND REHAB CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $401.05 | $224.59 | 2026-07-17 | MRF ↗ |
| San Leandro Hospital Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $401.05 | $224.59 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - ROSEVILLE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $401.05 | $224.59 | 2026-07-15 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $401.05 | $224.59 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL-SANTA CLARA Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $401.05 | $224.59 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - FRESNO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $401.05 | $224.59 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - FREMONT Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $401.05 | $224.59 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - VACAVILLE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $401.05 | $224.59 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - WALNUT CREEK Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $401.05 | $224.59 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $401.05 | $224.59 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - ANTIOCH Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $401.05 | $224.59 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL-SAN JOSE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $401.05 | $224.59 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - SOUTH SAN FRANCISCO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $401.05 | $224.59 | 2026-07-15 | MRF ↗ |
| SANTA ROSA MEDICAL CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $401.05 | $224.59 | 2026-07-18 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $401.05 | $224.59 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL MANTECA Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $401.05 | $224.59 | 2026-07-18 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL MODESTO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $401.05 | $224.59 | 2026-07-15 | MRF ↗ |
| SAN FRANCISCO VA MEDICAL CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $401.05 | $224.59 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - WEST LA Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $401.05 | $208.55 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - SOUTH BAY Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $401.05 | $208.55 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - BALDWIN PARK Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $401.05 | $208.55 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - LOS ANGELES Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $401.05 | $208.55 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - ORANGE COUNTY - IRVINE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $401.05 | $208.55 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - WOODLAND HILLS Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $401.05 | $208.55 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - PANORAMA CITY Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $401.05 | $208.55 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL FONTANA/ONTARIO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $401.05 | $208.55 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL, RIVERSIDE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $401.05 | $208.55 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - DOWNEY Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $401.05 | $208.55 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL FONTANA/ONTARIO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $401.05 | $208.55 | 2026-07-17 | MRF ↗ |
| ORO VALLEY HOSPITAL Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $401.05 | $208.55 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - SAN DIEGO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $401.05 | $208.55 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - SAN DIEGO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $401.05 | $208.55 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - ORANGE COUNTY - ANAHEIM Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $401.05 | $208.55 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - SAN MARCOS Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $401.05 | $208.55 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - WALNUT CREEK Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $401.05 | $224.59 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - VACAVILLE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $401.05 | $224.59 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $401.05 | $224.59 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - ANTIOCH Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $401.05 | $224.59 | 2026-07-15 | MRF ↗ |
| SAN FRANCISCO VA MEDICAL CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $401.05 | $224.59 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - REDWOOD CITY Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $401.05 | $224.59 | 2026-07-15 | MRF ↗ |
| SANTA ROSA MEDICAL CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $401.05 | $224.59 | 2026-07-18 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - FREMONT Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $401.05 | $224.59 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - ROSEVILLE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $401.05 | $224.59 | 2026-07-15 | MRF ↗ |
| San Leandro Hospital Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $401.05 | $224.59 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSP SO SACRAMENTO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $401.05 | $224.59 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - FRESNO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $401.05 | $224.59 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL AND REHAB CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $401.05 | $224.59 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL MANTECA Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $401.05 | $224.59 | 2026-07-18 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - SOUTH SAN FRANCISCO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $401.05 | $224.59 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL MODESTO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $401.05 | $224.59 | 2026-07-15 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $401.05 | $224.59 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $401.05 | $224.59 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL-SAN JOSE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $401.05 | $224.59 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL-SANTA CLARA Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $401.05 | $224.59 | 2026-07-15 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | WellCare | Medicare Advantage | $69.45 | $363.82 | — | 2025-06-28 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE | $75.60 | $503.99 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR BothFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE-Ped | $75.60 | $503.99 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE | $75.60 | $503.99 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | BLUE CROSS | Medicare PPO | $75.60 | $503.99 | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE | $75.60 | $503.99 | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South BothFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE-Ped | $75.60 | $503.99 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE | $75.60 | $503.99 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE BothFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE-Ped | $75.60 | $503.99 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | BLUE CROSS | BlueMedicare HMO | $75.60 | $503.99 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST BothFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE-Ped | $75.60 | $503.99 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST BothFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE-Ped | $75.60 | $503.99 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE | $75.60 | $503.99 | — | 2025-07-30 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $401.05 | $300.79 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL, RIVERSIDE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $401.05 | $208.55 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - SAN DIEGO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $401.05 | $208.55 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - WOODLAND HILLS Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $401.05 | $208.55 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - SOUTH BAY Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $401.05 | $208.55 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - DOWNEY Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $401.05 | $208.55 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - PANORAMA CITY Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $401.05 | $208.55 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL FONTANA/ONTARIO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $401.05 | $208.55 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - ORANGE COUNTY - ANAHEIM Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $401.05 | $208.55 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - BALDWIN PARK Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $401.05 | $208.55 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - ORANGE COUNTY - IRVINE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $401.05 | $208.55 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - LOS ANGELES Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $401.05 | $208.55 | 2026-07-15 | MRF ↗ |
| ORO VALLEY HOSPITAL Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $401.05 | $208.55 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL FONTANA/ONTARIO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $401.05 | $208.55 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - SAN MARCOS Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $401.05 | $208.55 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - WEST LA Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $401.05 | $208.55 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - SAN DIEGO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $401.05 | $208.55 | 2026-07-17 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | UNITED | EXCHANGE | $80.13 | $503.99 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | UNITED | EXCHANGE | $80.13 | $503.99 | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | UNITED | EXCHANGE | $80.13 | $503.99 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | UNITED | EXCHANGE | $80.13 | $503.99 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | UNITED | EXCHANGE | $80.13 | $503.99 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | MOLINA | EXCHANGE | $80.64 | $503.99 | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | MOLINA | EXCHANGE | $80.64 | $503.99 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | MOLINA | EXCHANGE | $80.64 | $503.99 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | MOLINA | EXCHANGE | $80.64 | $503.99 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | MOLINA | EXCHANGE | $80.64 | $503.99 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | BLUE CROSS | MyBlue | $81.19 | $503.99 | — | 2025-07-30 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $401.05 | $300.79 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL WESTSIDE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $401.05 | $340.90 | 2026-07-15 | MRF ↗ |
| KAISER SUNNYSIDE MEDICAL CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $401.05 | $340.90 | 2026-07-17 | MRF ↗ |
| ST JUDE CHILDRENS RESEARCH HOSPITAL InpatientFacility | Vantage | PPO | $84.60 | $141.00 | — | 2025-07-01 | MRF ↗ |
| ST JUDE CHILDRENS RESEARCH HOSPITAL OutpatientFacility | Health Choice - OK | ALL PRODUCTS | $84.60 | $141.00 | — | 2025-07-01 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | AVMED | Medicare | $85.17 | $503.99 | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | AVMED | Medicare | $85.17 | $503.99 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | AVMED | Medicare | $85.17 | $503.99 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | AVMED | Medicare | $85.17 | $503.99 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | AVMED | Medicare | $85.17 | $503.99 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | CIGNA | EXCHANGE | $85.68 | $503.99 | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | CIGNA | EXCHANGE | $85.68 | $503.99 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | BLUE CROSS | BLUE SELECT | $85.68 | $503.99 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | CIGNA | EXCHANGE | $85.68 | $503.99 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | CIGNA | EXCHANGE | $85.68 | $503.99 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | CIGNA | EXCHANGE | $85.68 | $503.99 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE BothFacility | Aetna Better Health | Healthy Kids | $90.72 | $503.99 | — | 2025-07-30 | MRF ↗ |
| KAISER SUNNYSIDE MEDICAL CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $401.05 | $340.90 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL WESTSIDE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $401.05 | $340.90 | 2026-07-15 | MRF ↗ |
| ST JUDE CHILDRENS RESEARCH HOSPITAL BothFacility | HUMANA | ALL PRODUCTS | $91.65 | $141.00 | — | 2025-07-01 | MRF ↗ |
| ST JUDE CHILDRENS RESEARCH HOSPITAL BothFacility | Vantage | PPO | $94.47 | $141.00 | — | 2025-07-01 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | BLUE CROSS | Simply Blue | $94.70 | $503.99 | — | 2025-07-30 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | CenCal Transplant Medi-Cal HMO | Medi-Cal HMO | — | $382.85 | $210.57 | 2026-03-29 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | TriWest Healthcare Alliance | Other Government | — | $382.85 | $210.57 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Anthem Medicare | Medicare | — | $382.85 | $210.57 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Health Plan of Nevada Medicare | Medicare | — | $382.85 | $210.57 | 2026-03-29 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | UCLA Health Medicare Advantage Plan | Medicare Advantage | $95.71 | $382.85 | $210.57 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Redlands Community Medicare | Medicare | — | $382.85 | $210.57 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | TriWest Healthcare Alliance | Other Government | — | $382.85 | $210.57 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Aetna Medicare | Medicare | $95.71 | $382.85 | $210.57 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Aetna Medicare | Medicare | $95.71 | $382.85 | $210.57 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Prime Health - Medicare | Medicare | — | $382.85 | $210.57 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | TriWest Healthcare Alliance | Other Government | — | $382.85 | $210.57 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Torrance Memorial Medicare | HMO-Medicare | — | $382.85 | $210.57 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Redlands Community Medicare | Medicare | — | $382.85 | $210.57 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Centivo | PPO | — | $382.85 | $210.57 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Centivo | PPO | — | $382.85 | $210.57 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Central Health Plan | Medicare HMO | — | $382.85 | $210.57 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | UCLA Health Medicare Advantage Plan | Medicare Advantage | $95.71 | $382.85 | $210.57 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Health Plan of Nevada Medicare | Medicare | — | $382.85 | $210.57 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | UHC Mediare Advantage | Medicare Advantage | — | $382.85 | $210.57 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Prime Health - Medicare | Medicare | — | $382.85 | $210.57 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | UCLA Health Medicare Advantage Plan | Medicare Advantage | $95.71 | $382.85 | $210.57 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | St. Jude | Medicare HMO | — | $382.85 | $210.57 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Torrance Memorial Medicare | HMO-Medicare | — | $382.85 | $210.57 | 2026-03-29 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | BLUE CROSS | HMO | $97.98 | $503.99 | — | 2025-07-30 | MRF ↗ |
| ST JUDE CHILDRENS RESEARCH HOSPITAL BothFacility | Tricare East | PPO | $98.70 | $141.00 | — | 2025-07-01 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | Solis Health Plan | Medicare | $100.80 | $503.99 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | BLUE CROSS | BlueMedicare HMO | $100.80 | $503.99 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | Solis Health Plan | Medicare | $100.80 | $503.99 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | Solis Health Plan | Medicare | $100.80 | $503.99 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | Solis Health Plan | Medicare | $100.80 | $503.99 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | BLUE CROSS | Medicare PPO | $100.80 | $503.99 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | BLUE CROSS | Medicare PPO | $100.80 | $503.99 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | BLUE CROSS | BlueMedicare HMO | $100.80 | $503.99 | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | Solis Health Plan | Medicare | $100.80 | $503.99 | — | 2025-07-30 | MRF ↗ |
| ST JUDE CHILDRENS RESEARCH HOSPITAL OutpatientFacility | Optum Health | ALL PRODUCTS | $101.52 | $141.00 | — | 2025-07-01 | MRF ↗ |
| ST JUDE CHILDRENS RESEARCH HOSPITAL OutpatientFacility | Home State Health | MANAGED MEDICAID | $105.75 | $141.00 | — | 2025-07-01 | MRF ↗ |
| ST JUDE CHILDRENS RESEARCH HOSPITAL BothFacility | AETNA | ALL PRODUCTS | $105.75 | $141.00 | — | 2025-07-01 | MRF ↗ |
| MEMORIAL HOSPITAL WEST BothFacility | Aetna Better Health | Healthy Kids-Ped | $105.84 | $503.99 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | Aetna Better Health | Healthy Kids | $105.84 | $503.99 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | Aetna Better Health | Healthy Kids | $105.84 | $503.99 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR BothFacility | Aetna Better Health | Healthy Kids-Ped | $105.84 | $503.99 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST BothFacility | Aetna Better Health | Healthy Kids-Ped | $105.84 | $503.99 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | Aetna Better Health | Healthy Kids | $105.84 | $503.99 | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | Aetna Better Health | Healthy Kids | $105.84 | $503.99 | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South BothFacility | Aetna Better Health | Healthy Kids-Ped | $105.84 | $503.99 | — | 2025-07-30 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Gold Coast Health Plan | HMO | $107.20 | $382.85 | $210.57 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Gold Coast Health Plan | HMO | $107.20 | $382.85 | $210.57 | 2026-03-29 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | Molina MI Health Link | MEDICARE ADVANTAGE | $109.15 | $363.82 | — | 2025-06-28 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | Molina MI Health Link | MEDICARE ADVANTAGE | $109.15 | $363.82 | — | 2025-06-28 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | MOLINA | MARKETPLACE | $109.15 | $363.82 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | MOLINA | MARKETPLACE | $109.15 | $363.82 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | MOLINA | MARKETPLACE | $109.15 | $363.82 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | Molina MI Health Link | MEDICARE ADVANTAGE | $109.15 | $363.82 | — | 2025-06-28 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Anthem Workers Comp | Workers Comp | $109.84 | $382.85 | $210.57 | 2026-03-29 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | WellCare | Medicare Advantage | $109.87 | $363.82 | — | 2025-06-28 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Inpatient | Fidelis Wellcare | Medicaid | $111.20 | $585.75 | $585.75 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Inpatient | United Healthcare | Medicaid | $111.20 | $585.75 | $585.75 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Inpatient | Aetna | Better Health Medicaid | $111.20 | $585.75 | $585.75 | 2026-07-15 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | Anthem Vivity, Anthem HMO | HMO-City of LA | $112.21 | $382.85 | $210.57 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Anthem Vivity-Anthem HMO | All Products-HMO | $112.21 | $382.85 | $210.57 | 2026-03-29 | MRF ↗ |
| ST JUDE CHILDRENS RESEARCH HOSPITAL BothFacility | Private Health Care Systems | ALL PRODUCTS | $112.80 | $141.00 | — | 2025-07-01 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Inpatient | Healthnet Federal | Ppo Pc3 | $114.73 | $585.75 | $585.75 | 2026-07-15 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | BLUE CROSS | BlueMedicare HMO | $115.92 | $503.99 | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | BLUE CROSS | Medicare PPO | $115.92 | $503.99 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | BLUE CROSS | NetworkBlue/BlueOptions | $119.40 | $503.99 | — | 2025-07-30 | MRF ↗ |
| ST JUDE CHILDRENS RESEARCH HOSPITAL OutpatientFacility | MS Physicians Care Network | ALL PRODUCTS | $119.85 | $141.00 | — | 2025-07-01 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Anthem Vivity, Anthem HMO | HMO-City of LA | $124.50 | $382.85 | $210.57 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | UC Care - PPO | PPO | $125.57 | $382.85 | $210.57 | 2026-03-29 | MRF ↗ |
| MEMORIAL HOSPITAL WEST InpatientFacility | Aetna Better Health | Healthy Kids-Ped | $126.00 | $503.99 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR InpatientFacility | Aetna Better Health | Healthy Kids-Ped | $126.00 | $503.99 | — | 2025-07-30 | 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.