61958120101 — Elviteg-cob-emtri-tenofo Disop 150-150-200-300 Mg Tab 30 Each Bottle
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). ELVITEG-COB-EMTRI-TENOFO DISOP 150-150-200-300 MG TAB 30 EACH BOTTLE (NDC 61958120101) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/61958120101?code_type=NDC
MLA (9th ed.)
“ELVITEG-COB-EMTRI-TENOFO DISOP 150-150-200-300 MG TAB 30 EACH BOTTLE (NDC 61958120101) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/61958120101?code_type=NDC. Accessed .
Chicago (notes-bibliography)
“ELVITEG-COB-EMTRI-TENOFO DISOP 150-150-200-300 MG TAB 30 EACH BOTTLE (NDC 61958120101) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/61958120101?code_type=NDC.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $214–$494 (25th–75th percentile) across 78 hospitals · 302 payers.
“Negotiated” is the hospital’s negotiated facility rate for this NDC 61958120101 — 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 |
|---|---|---|---|---|---|---|---|
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | HAP | Self Insured | $2.10 | $419.13 | — | 2025-06-28 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | HAP | Self Insured | $2.10 | $419.13 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | HAP | Self Insured | $2.10 | $419.13 | — | 2025-06-28 | MRF ↗ |
| ST JUDE CHILDRENS RESEARCH HOSPITAL OutpatientFacility | Empower | MANAGED MEDICAID | $21.00 | $160.00 | — | 2025-07-01 | MRF ↗ |
| ST JUDE CHILDRENS RESEARCH HOSPITAL OutpatientFacility | HealthCare Connections LA | MANAGED MEDICAID | $24.40 | $160.00 | — | 2025-07-01 | MRF ↗ |
| KULA HOSPITAL Outpatient | Hmsa | Ppo | $26.18 | $436.34 | $170.00 | 2026-07-15 | MRF ↗ |
| KULA HOSPITAL Outpatient | Hmsa | Hmo | $26.18 | $436.34 | $170.00 | 2026-07-15 | MRF ↗ |
| ST JUDE CHILDRENS RESEARCH HOSPITAL OutpatientFacility | Healthy Blue | MANAGED MEDICAID | $40.00 | $160.00 | — | 2025-07-01 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | AETNA | MEDICARE | $40.45 | $358.00 | $53.70 | 2025-12-23 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | AETNA | MEDICARE | $40.45 | $358.00 | $53.70 | 2025-12-23 | MRF ↗ |
| LOYOLA GOTTLIEB MEMORIAL HOSPITAL OutpatientFacility | Cigna | HMO | $43.97 | $146.08 | $27.76 | 2026-03-31 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Inpatient | Aetna | Hmo | $47.09 | $675.17 | $675.17 | 2026-07-15 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | PENSACOLA | CHRISTIAN COLL | $53.70 | $358.00 | $53.70 | 2025-12-23 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | PENSACOLA | CHRISTIAN COLL | $53.70 | $358.00 | $53.70 | 2025-12-23 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | FL BLUE | MY BLUE NETWORK | $53.70 | $358.00 | $53.70 | 2025-12-23 | MRF ↗ |
| KULA HOSPITAL Outpatient | Uhc | Quest | $60.00 | $436.34 | $170.00 | 2026-07-15 | MRF ↗ |
| LOYOLA GOTTLIEB MEMORIAL HOSPITAL OutpatientFacility | Cigna | PPO | $62.23 | $146.08 | $27.76 | 2026-03-31 | MRF ↗ |
| LOYOLA GOTTLIEB MEMORIAL HOSPITAL OutpatientFacility | Aetna | All Products | $64.28 | $146.08 | $27.76 | 2026-03-31 | MRF ↗ |
| LAKESIDE MEDICAL CENTER OutpatientFacility | UHC | Managed Medicaid | $66.88 | $669.00 | — | 2025-12-02 | MRF ↗ |
| LAKESIDE MEDICAL CENTER OutpatientFacility | UHC | CHIP | $66.88 | $669.00 | — | 2025-12-02 | MRF ↗ |
| LOYOLA GOTTLIEB MEMORIAL HOSPITAL BothFacility | BCBS IL | Blue Choice | $67.49 | $146.08 | $27.76 | 2026-03-31 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | FL BLUE | HEALTH OPTIONS HMO | $68.02 | $358.00 | $53.70 | 2025-12-23 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | FL BLUE | SIMPLY BLUE NETWORK | $68.02 | $358.00 | $53.70 | 2025-12-23 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | FL BLUE | BLUE SELECT | $68.02 | $358.00 | $53.70 | 2025-12-23 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - FRESNO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $461.96 | $258.70 | 2026-07-17 | MRF ↗ |
| SAN FRANCISCO VA MEDICAL CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $461.96 | $258.70 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - SOUTH SAN FRANCISCO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $461.96 | $258.70 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL MODESTO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $461.96 | $258.70 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL-SAN JOSE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $461.96 | $258.70 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - FREMONT Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $461.96 | $258.70 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $461.96 | $258.70 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - ANTIOCH Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $461.96 | $258.70 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSP SO SACRAMENTO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $461.96 | $258.70 | 2026-07-15 | MRF ↗ |
| SANTA ROSA MEDICAL CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $461.96 | $258.70 | 2026-07-18 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL MANTECA Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $461.96 | $258.70 | 2026-07-18 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - REDWOOD CITY Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $461.96 | $258.70 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - VACAVILLE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $461.96 | $258.70 | 2026-07-17 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $461.96 | $258.70 | 2026-07-17 | MRF ↗ |
| San Leandro Hospital Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $461.96 | $258.70 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL-SANTA CLARA Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $461.96 | $258.70 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $461.96 | $258.70 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - WALNUT CREEK Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $461.96 | $258.70 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - ROSEVILLE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $461.96 | $258.70 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL AND REHAB CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $461.96 | $258.70 | 2026-07-17 | MRF ↗ |
| LOYOLA GOTTLIEB MEMORIAL HOSPITAL OutpatientFacility | UHC | Navigate Core | $73.04 | $146.08 | $27.76 | 2026-03-31 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | FL BLUE | MY BLUE NETWORK | $75.18 | $358.00 | $53.70 | 2025-12-23 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - SAN DIEGO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $461.96 | $240.22 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - ORANGE COUNTY - ANAHEIM Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $461.96 | $240.22 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - WOODLAND HILLS Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $461.96 | $240.22 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL FONTANA/ONTARIO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $461.96 | $240.22 | 2026-07-17 | MRF ↗ |
| ORO VALLEY HOSPITAL Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $461.96 | $240.22 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL FONTANA/ONTARIO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $461.96 | $240.22 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - ORANGE COUNTY - IRVINE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $461.96 | $240.22 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL, RIVERSIDE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $461.96 | $240.22 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - PANORAMA CITY Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $461.96 | $240.22 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - SOUTH BAY Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $461.96 | $240.22 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - DOWNEY Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $461.96 | $240.22 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - SAN MARCOS Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $461.96 | $240.22 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - WEST LA Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $461.96 | $240.22 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - SAN DIEGO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $461.96 | $240.22 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - BALDWIN PARK Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $461.96 | $240.22 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - LOS ANGELES Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $461.96 | $240.22 | 2026-07-15 | MRF ↗ |
| LOYOLA GOTTLIEB MEMORIAL HOSPITAL OutpatientFacility | UHC | All Products | $75.96 | $146.08 | $27.76 | 2026-03-31 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - FRESNO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $461.96 | $258.70 | 2026-07-17 | MRF ↗ |
| San Leandro Hospital Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $461.96 | $258.70 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - ROSEVILLE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $461.96 | $258.70 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $461.96 | $258.70 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL AND REHAB CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $461.96 | $258.70 | 2026-07-17 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $461.96 | $258.70 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $461.96 | $258.70 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSP SO SACRAMENTO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $461.96 | $258.70 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - VACAVILLE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $461.96 | $258.70 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - FREMONT Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $461.96 | $258.70 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL-SANTA CLARA Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $461.96 | $258.70 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL MANTECA Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $461.96 | $258.70 | 2026-07-18 | MRF ↗ |
| SANTA ROSA MEDICAL CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $461.96 | $258.70 | 2026-07-18 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL-SAN JOSE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $461.96 | $258.70 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - WALNUT CREEK Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $461.96 | $258.70 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - SOUTH SAN FRANCISCO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $461.96 | $258.70 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - REDWOOD CITY Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $461.96 | $258.70 | 2026-07-15 | MRF ↗ |
| SAN FRANCISCO VA MEDICAL CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $461.96 | $258.70 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - ANTIOCH Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $461.96 | $258.70 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL MODESTO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $461.96 | $258.70 | 2026-07-15 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | UHC | MCARE ADV DUAL PLAN | $78.76 | $358.00 | $53.70 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | WELLCARE | MCARE HMO | $78.76 | $358.00 | $53.70 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | UHC | MCARE ADV PLN | $78.76 | $358.00 | $53.70 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | BC FL | MEDICARE HMO | $78.76 | $358.00 | $53.70 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | AETNA | MEDICARE | $78.76 | $358.00 | $53.70 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | HUMANA | MCARE CHOICE PPO | $78.76 | $358.00 | $53.70 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | WELLCARE | MCARE HMO DUAL PLAN | $78.76 | $358.00 | $53.70 | 2025-12-23 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | WellCare | Medicare Advantage | $80.01 | $419.13 | — | 2025-06-28 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | FL BLUE | NWB - BLUE OPTIONS | $82.34 | $358.00 | $53.70 | 2025-12-23 | MRF ↗ |
| LOYOLA GOTTLIEB MEMORIAL HOSPITAL BothFacility | BCBS IL | PPO | $84.00 | $146.08 | $27.76 | 2026-03-31 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | UHC OF FL | NEIGHBORHOOD PLAN | $84.85 | $358.00 | $53.70 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | FL BLUE | MY BLUE NETWORK | $85.92 | $358.00 | $53.70 | 2025-12-23 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | FL BLUE | BLUE SELECT | $85.92 | $358.00 | $53.70 | 2025-12-23 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | FL BLUE | SIMPLY BLUE NETWORK | $85.92 | $358.00 | $53.70 | 2025-12-23 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE | $87.14 | $580.92 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE | $87.14 | $580.92 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE BothFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE-Ped | $87.14 | $580.92 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR BothFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE-Ped | $87.14 | $580.92 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST BothFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE-Ped | $87.14 | $580.92 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | BLUE CROSS | Medicare PPO | $87.14 | $580.92 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE | $87.14 | $580.92 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE | $87.14 | $580.92 | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South BothFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE-Ped | $87.14 | $580.92 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | BLUE CROSS | BlueMedicare HMO | $87.14 | $580.92 | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE | $87.14 | $580.92 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST BothFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE-Ped | $87.14 | $580.92 | — | 2025-07-30 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $461.96 | $346.47 | 2026-07-15 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | BCBS | Medicare Advantage-PPO | $87.55 | $564.87 | $310.68 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | BCBS | Medicare Advantage-PPO | $87.55 | $564.87 | $310.68 | 2026-03-31 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | UHC OF FL | POS/HMO | $88.78 | $358.00 | $53.70 | 2025-12-23 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | UHC COMMUNITY | MCAID HMO | $89.50 | $358.00 | $53.70 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | UHC COMMUNITY | MCAID HMO | $89.50 | $358.00 | $53.70 | 2025-12-23 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | UHC COMMUNITY | MCAID HMO | $89.50 | $358.00 | $53.70 | 2025-12-23 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - WEST LA Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $461.96 | $240.22 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - BALDWIN PARK Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $461.96 | $240.22 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - SAN DIEGO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $461.96 | $240.22 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - WOODLAND HILLS Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $461.96 | $240.22 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL FONTANA/ONTARIO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $461.96 | $240.22 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - PANORAMA CITY Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $461.96 | $240.22 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - SOUTH BAY Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $461.96 | $240.22 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - ORANGE COUNTY - ANAHEIM Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $461.96 | $240.22 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - SAN DIEGO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $461.96 | $240.22 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - ORANGE COUNTY - IRVINE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $461.96 | $240.22 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - SAN MARCOS Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $461.96 | $240.22 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - LOS ANGELES Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $461.96 | $240.22 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL, RIVERSIDE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $461.96 | $240.22 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL FONTANA/ONTARIO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $461.96 | $240.22 | 2026-07-17 | MRF ↗ |
| ORO VALLEY HOSPITAL Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $461.96 | $240.22 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - DOWNEY Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $461.96 | $240.22 | 2026-07-17 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | UNITED | EXCHANGE | $92.37 | $580.92 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | UNITED | EXCHANGE | $92.37 | $580.92 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | UNITED | EXCHANGE | $92.37 | $580.92 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | UNITED | EXCHANGE | $92.37 | $580.92 | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | UNITED | EXCHANGE | $92.37 | $580.92 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | MOLINA | EXCHANGE | $92.95 | $580.92 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | MOLINA | EXCHANGE | $92.95 | $580.92 | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | MOLINA | EXCHANGE | $92.95 | $580.92 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | MOLINA | EXCHANGE | $92.95 | $580.92 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | MOLINA | EXCHANGE | $92.95 | $580.92 | — | 2025-07-30 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | BC FL | MEDICARE HMO | $93.08 | $358.00 | $53.70 | 2025-12-23 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | BLUE CROSS | MyBlue | $93.59 | $580.92 | — | 2025-07-30 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | UHC OF FL | POS/HMO | $94.87 | $358.00 | $53.70 | 2025-12-23 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | UHC OF FL | POS/HMO | $94.87 | $358.00 | $53.70 | 2025-12-23 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $461.96 | $346.47 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL WESTSIDE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $461.96 | $392.67 | 2026-07-15 | MRF ↗ |
| KAISER SUNNYSIDE MEDICAL CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $461.96 | $392.67 | 2026-07-17 | MRF ↗ |
| ST JUDE CHILDRENS RESEARCH HOSPITAL OutpatientFacility | Health Choice - OK | ALL PRODUCTS | $96.00 | $160.00 | — | 2025-07-01 | MRF ↗ |
| ST JUDE CHILDRENS RESEARCH HOSPITAL InpatientFacility | Vantage | PPO | $96.00 | $160.00 | — | 2025-07-01 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | FL BLUE | PPC-BLUE CHOICE | $96.66 | $358.00 | $53.70 | 2025-12-23 | MRF ↗ |
| LOYOLA GOTTLIEB MEMORIAL HOSPITAL BothFacility | BCBS IL | HMO | $97.87 | $146.08 | $27.76 | 2026-03-31 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | AVMED | Medicare | $98.18 | $580.92 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | AVMED | Medicare | $98.18 | $580.92 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | AVMED | Medicare | $98.18 | $580.92 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | AVMED | Medicare | $98.18 | $580.92 | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | AVMED | Medicare | $98.18 | $580.92 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | CIGNA | EXCHANGE | $98.76 | $580.92 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | BLUE CROSS | BLUE SELECT | $98.76 | $580.92 | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | CIGNA | EXCHANGE | $98.76 | $580.92 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | CIGNA | EXCHANGE | $98.76 | $580.92 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | CIGNA | EXCHANGE | $98.76 | $580.92 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | CIGNA | EXCHANGE | $98.76 | $580.92 | — | 2025-07-30 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | FL BLUE | SIMPLY BLUE NETWORK | $100.24 | $358.00 | $53.70 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | FL BLUE | BLUE SELECT | $100.24 | $358.00 | $53.70 | 2025-12-23 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | FL BLUE | HEALTH OPTIONS HMO | $100.24 | $358.00 | $53.70 | 2025-12-23 | MRF ↗ |
| LOYOLA GOTTLIEB MEMORIAL HOSPITAL BothFacility | BCBS IL | Blue Precision | $101.67 | $146.08 | $27.76 | 2026-03-31 | MRF ↗ |
| FLAGLER HOSPITAL OutpatientFacility | Aetna | Medicare Advantage | $101.68 | $564.87 | $310.68 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | BCBS | Medicare Advantage-HMO | $101.68 | $564.87 | $310.68 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | BCBS | Medicare Advantage-HMO | $101.68 | $564.87 | $310.68 | 2026-03-31 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | FL BLUE | INDEMNITY | $103.82 | $358.00 | $53.70 | 2025-12-23 | MRF ↗ |
| ST JUDE CHILDRENS RESEARCH HOSPITAL BothFacility | HUMANA | ALL PRODUCTS | $104.00 | $160.00 | — | 2025-07-01 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE BothFacility | Aetna Better Health | Healthy Kids | $104.57 | $580.92 | — | 2025-07-30 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL WESTSIDE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $461.96 | $392.67 | 2026-07-15 | MRF ↗ |
| KAISER SUNNYSIDE MEDICAL CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $461.96 | $392.67 | 2026-07-17 | MRF ↗ |
| LOYOLA GOTTLIEB MEMORIAL HOSPITAL BothFacility | Aetna | FH-Medical Rental | $106.64 | $146.08 | $27.76 | 2026-03-31 | MRF ↗ |
| LAKESIDE MEDICAL CENTER OutpatientFacility | BCBS | Medicare Advantage PPO | $107.04 | $669.00 | — | 2025-12-02 | MRF ↗ |
| ST JUDE CHILDRENS RESEARCH HOSPITAL BothFacility | Vantage | PPO | $107.20 | $160.00 | — | 2025-07-01 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | HOSPICE REGENCY | ALL PRODUCTS | $107.40 | $358.00 | $53.70 | 2025-12-23 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | HOSPICE REGENCY | ALL PRODUCTS | $107.40 | $358.00 | $53.70 | 2025-12-23 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | WellCare | Medicare Advantage | $107.51 | $419.13 | — | 2025-06-28 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | BLUE CROSS | Simply Blue | $109.15 | $580.92 | — | 2025-07-30 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Central Health Plan | Medicare HMO | — | $441.29 | $242.71 | 2026-03-29 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | UCLA Health Medicare Advantage Plan | Medicare Advantage | $110.32 | $441.29 | $242.71 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | CenCal Transplant Medi-Cal HMO | Medi-Cal HMO | — | $441.29 | $242.71 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Torrance Memorial Medicare | HMO-Medicare | — | $441.29 | $242.71 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Health Plan of Nevada Medicare | Medicare | — | $441.29 | $242.71 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Aetna Medicare | Medicare | $110.32 | $441.29 | $242.71 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | UHC Mediare Advantage | Medicare Advantage | — | $441.29 | $242.71 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | UCLA Health Medicare Advantage Plan | Medicare Advantage | $110.32 | $441.29 | $242.71 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | St. Jude | Medicare HMO | — | $441.29 | $242.71 | 2026-03-29 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | TriWest Healthcare Alliance | Other Government | — | $441.29 | $242.71 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Centivo | PPO | — | $441.29 | $242.71 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Prime Health - Medicare | Medicare | — | $441.29 | $242.71 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Redlands Community Medicare | Medicare | — | $441.29 | $242.71 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | TriWest Healthcare Alliance | Other Government | — | $441.29 | $242.71 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | UCLA Health Medicare Advantage Plan | Medicare Advantage | $110.32 | $441.29 | $242.71 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Torrance Memorial Medicare | HMO-Medicare | — | $441.29 | $242.71 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Aetna Medicare | Medicare | $110.32 | $441.29 | $242.71 | 2026-03-29 | 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.