63664 — Revise Spine Eltrd Plate
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). Revise spine eltrd plate (OTHER 63664) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/63664?code_type=OTHER
MLA (9th ed.)
“Revise spine eltrd plate (OTHER 63664) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/63664?code_type=OTHER. Accessed .
Chicago (notes-bibliography)
“Revise spine eltrd plate (OTHER 63664) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/63664?code_type=OTHER.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $882–$13,539 (25th–75th percentile) across 183 hospitals · 413 payers.
“Negotiated” is the hospital’s negotiated facility rate for this OTHER 63664 — 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 |
|---|---|---|---|---|---|---|---|
| PENN STATE HEALTH HAMPDEN MEDICAL CENTER | Highmark Choice Blue | — | $25.70 | $63.00 | $18.47 | 2026-05-31 | MRF ↗ |
| VIRGINIA MASON MEDICAL CENTER Outpatient | First Choice | Commercial | $26.01 | — | — | 2026-05-27 | MRF ↗ |
| VIRGINIA MASON MEDICAL CENTER Outpatient | Aetna | Medicare Advantage Ppo | $26.34 | — | — | 2026-05-27 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Arkansas Total Care | Medicaid | $30.08 | — | — | 2026-05-09 | MRF ↗ |
| PENN STATE HEALTH HAMPDEN MEDICAL CENTER | Cigna | — | $30.67 | $63.00 | $18.47 | 2026-05-31 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Caresource | Medicaid | $31.28 | — | — | 2026-05-09 | MRF ↗ |
| PENN STATE HEALTH HAMPDEN MEDICAL CENTER | Uhc Comm | — | $31.39 | $63.00 | $18.47 | 2026-05-31 | MRF ↗ |
| PENN STATE HEALTH HAMPDEN MEDICAL CENTER | Highmark Comm | — | $32.13 | $63.00 | $18.47 | 2026-05-31 | MRF ↗ |
| ESKENAZI HEALTH Outpatient | Aetna Commercial Facility | Aetna Commercial Facility | $32.55 | $85.42 | $85.42 | 2026-05-27 | MRF ↗ |
| ESKENAZI HEALTH Outpatient | Umr H&H Employees Facility | Umr Hh Employees Facility | $32.74 | $85.42 | $85.42 | 2026-05-27 | MRF ↗ |
| ESKENAZI HEALTH Inpatient | Umr H&H Employees Facility | Umr Hh Employees Facility | $33.13 | $85.42 | $85.42 | 2026-05-27 | MRF ↗ |
| ESKENAZI HEALTH Outpatient | Humana Medicare Facility | Humana Medicare Facility | $34.17 | $85.42 | $85.42 | 2026-05-27 | MRF ↗ |
| VIRGINIA MASON MEDICAL CENTER Outpatient | Aetna | Medicare Advantage Hmo | $35.63 | — | — | 2026-05-27 | MRF ↗ |
| VIRGINIA MASON MEDICAL CENTER Outpatient | Aetna | Medicare Advantage | $38.30 | — | — | 2026-05-27 | MRF ↗ |
| ESKENAZI HEALTH Inpatient | Sagamore Commercial Facility | Sagamore Commercial Facility | $38.95 | $85.42 | $85.42 | 2026-05-27 | MRF ↗ |
| ESKENAZI HEALTH Outpatient | United Charter (Sg Commercial) Facility | United Charter (Sg Commercial) Facility | $40.32 | $85.42 | $85.42 | 2026-05-27 | MRF ↗ |
| ESKENAZI HEALTH Outpatient | Eskenazi Health | Anthem Facility Exchange | $42.54 | $85.42 | $85.42 | 2026-05-27 | MRF ↗ |
| ESKENAZI HEALTH Outpatient | United Medicare Facility | United Medicare Facility | $42.54 | $85.42 | $85.42 | 2026-05-27 | MRF ↗ |
| ESKENAZI HEALTH Outpatient | Zing Medicare Facility | Zing Medicare Facility | $42.54 | $85.42 | $85.42 | 2026-05-27 | MRF ↗ |
| ESKENAZI HEALTH Outpatient | Cigna Ppo Commercial Facility | Cigna Ppo Commercial Facility | $42.54 | $85.42 | $85.42 | 2026-05-27 | MRF ↗ |
| ESKENAZI HEALTH Outpatient | United Commercial Facility | United Commercial Facility | $42.54 | $85.42 | $85.42 | 2026-05-27 | MRF ↗ |
| ESKENAZI HEALTH Outpatient | Caresource Exchange Facility | Caresource Exchange Facility | $42.54 | $85.42 | $85.42 | 2026-05-27 | MRF ↗ |
| ESKENAZI HEALTH Outpatient | Siho Commercial Facility | Siho Commercial Facility | $42.54 | $85.42 | $85.42 | 2026-05-27 | MRF ↗ |
| ESKENAZI HEALTH Outpatient | Anthem | Anthem Medicare Advantage | $42.54 | $85.42 | $85.42 | 2026-05-27 | MRF ↗ |
| ESKENAZI HEALTH Outpatient | Umr H&H Employees Facility | Umr Hh Employees Facility | $42.54 | $85.42 | $85.42 | 2026-05-27 | MRF ↗ |
| ESKENAZI HEALTH Outpatient | Workers Comp | Workers Comp - Generic | $42.54 | $85.42 | $85.42 | 2026-05-27 | MRF ↗ |
| ESKENAZI HEALTH Outpatient | Sagamore Commercial Facility | Sagamore Commercial Facility | $42.54 | $85.42 | $85.42 | 2026-05-27 | MRF ↗ |
| ESKENAZI HEALTH Outpatient | Aetna Medicare Advantage Facility | Aetna Medicare Advantage Facility | $42.54 | $85.42 | $85.42 | 2026-05-27 | MRF ↗ |
| ESKENAZI HEALTH Outpatient | Cigna Hmo/Oap Commercial Facility | Cigna Hmo/Oap Commercial Facility | $42.54 | $85.42 | $85.42 | 2026-05-27 | MRF ↗ |
| ESKENAZI HEALTH Outpatient | United Charter (Sg Commercial) Facility | United Charter (Sg Commercial) Facility | $42.54 | $85.42 | $85.42 | 2026-05-27 | MRF ↗ |
| ESKENAZI HEALTH Outpatient | Mdwise Medicare Facility | Mdwise Medicare Facility | $42.54 | $85.42 | $85.42 | 2026-05-27 | MRF ↗ |
| ESKENAZI HEALTH Outpatient | Communicare Ma Facility | Communicare Ma Facility | $42.54 | $85.42 | $85.42 | 2026-05-27 | MRF ↗ |
| ESKENAZI HEALTH Outpatient | Aetna Commercial Facility | Aetna Commercial Facility | $42.54 | $85.42 | $85.42 | 2026-05-27 | MRF ↗ |
| ESKENAZI HEALTH Outpatient | Encore Main Commercial Facility | Encore Main Commercial Facility | $42.54 | $85.42 | $85.42 | 2026-05-27 | MRF ↗ |
| ESKENAZI HEALTH Outpatient | United Commercial Facility | United Commercial Facility | $45.79 | $85.42 | $85.42 | 2026-05-27 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Granite State Health Plan | New Hampshire Healthy Families - Nh Managed Medicaid | $60.96 | — | — | 2026-05-08 | MRF ↗ |
| ESKENAZI HEALTH Inpatient | Siho Commercial Facility | Siho Commercial Facility | $64.06 | $85.42 | $85.42 | 2026-05-27 | MRF ↗ |
| ESKENAZI HEALTH Outpatient | Cigna Hmo/Oap Commercial Facility | Cigna Hmo/Oap Commercial Facility | $72.61 | $85.42 | $85.42 | 2026-05-27 | MRF ↗ |
| ESKENAZI HEALTH Outpatient | Cigna Ppo Commercial Facility | Cigna Ppo Commercial Facility | $72.61 | $85.42 | $85.42 | 2026-05-27 | MRF ↗ |
| ESKENAZI HEALTH Inpatient | Encore Main Commercial Facility | Encore Main Commercial Facility | $72.61 | $85.42 | $85.42 | 2026-05-27 | MRF ↗ |
| GRADY MEMORIAL HOSPITAL Outpatient | Caresource | Commercial | $76.26 | — | — | 2026-05-07 | MRF ↗ |
| JASPER MEMORIAL HOSPITAL Outpatient | Peach State | Medicaid | $76.26 | — | — | 2026-05-06 | MRF ↗ |
| GRADY MEMORIAL HOSPITAL Outpatient | Amerigroup | Medicaid | $76.26 | — | — | 2026-05-07 | MRF ↗ |
| GRADY MEMORIAL HOSPITAL Outpatient | Peach State | Medicaid | $76.26 | — | — | 2026-05-07 | MRF ↗ |
| JASPER MEMORIAL HOSPITAL Outpatient | Amerigroup | Medicaid | $76.26 | — | — | 2026-05-06 | MRF ↗ |
| JASPER MEMORIAL HOSPITAL Outpatient | Caresource | Commercial | $76.26 | — | — | 2026-05-06 | MRF ↗ |
| ESKENAZI HEALTH Inpatient | Eskenazi Health | Anthem Facility Exchange | $85.42 | $85.42 | $85.42 | 2026-05-27 | MRF ↗ |
| ESKENAZI HEALTH Inpatient | Cigna | Cigna Exchange Facility | $85.42 | $85.42 | $85.42 | 2026-05-27 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Health Alliance | Commercial | $86.26 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Health Alliance | Commercial | $86.26 | — | — | 2026-05-24 | MRF ↗ |
| GILLETTE CHILDRENS SPECIALTY HOSPITAL Outpatient | Ucare | Managed Medicaid | $96.94 | — | — | 2026-05-09 | MRF ↗ |
| VIRGINIA MASON MEDICAL CENTER Outpatient | Aetna | Medicare Advantage | $102.78 | — | — | 2026-05-27 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Upmc | Commercial | $116.16 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Upmc | Commercial | $116.16 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Aetna | Coventry | $121.18 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Aetna | Coventry | $121.18 | — | — | 2026-05-14 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Humana Choicecare | Medicare | $122.33 | — | — | 2026-05-09 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Viva | Commercial | $124.08 | — | — | 2026-05-06 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Viva | Medicare Advantage | $124.08 | — | — | 2026-05-06 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Humana | Medicare Advantage | $124.08 | — | — | 2026-05-06 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Aetna | Commercial | $124.08 | — | — | 2026-05-06 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Blue Cross | Medicare Advantage | $124.08 | — | — | 2026-05-06 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Cigna | Commercial | $124.08 | — | — | 2026-05-06 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Simpra | Medicare Advantage | $124.08 | — | — | 2026-05-06 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Cigna | Commercial | $124.08 | — | — | 2026-05-06 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Humana | Medicare Advantage | $124.70 | — | — | 2026-05-23 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Humana | Medicare Advantage | $124.70 | — | — | 2026-05-13 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Viva | Medicare Advantage | $124.70 | — | — | 2026-05-13 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Simpra | Medicare Advantage | $124.70 | — | — | 2026-05-13 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Viva | Medicare Advantage | $124.70 | — | — | 2026-05-13 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Viva | Medicare Advantage | $124.70 | — | — | 2026-05-23 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Simpra | Medicare Advantage | $124.70 | — | — | 2026-05-23 | MRF ↗ |
| THE EAST ALABAMA HEALTHCARE AUTHORITY Outpatient | Viva | Medicare Advantage | $124.70 | — | — | 2026-05-23 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Bcbs | Medicare | $124.78 | — | — | 2026-05-09 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Ambetter | Commercial | $124.78 | — | — | 2026-05-09 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Community Blue Mcr Adv | $126.90 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Community Blue Mcr Adv | $126.90 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Complete Blue Mcr Adv | $126.90 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Complete Blue Mcr Adv | $126.90 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Freedom Blue Mcr Adv | $128.25 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Freedom Blue Mcr Adv | $128.25 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS CONNELLSVILLE Outpatient | Blue Cross | Freedom Blue Mcr Adv | $128.25 | — | — | 2026-05-09 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Wellcare | Medicare | $128.45 | — | — | 2026-05-09 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Cigna Healthspring | Medicare | $128.45 | — | — | 2026-05-09 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Windsor | Medicare | $128.45 | — | — | 2026-05-09 | MRF ↗ |
| PENN HIGHLANDS CONNELLSVILLE Outpatient | Blue Cross | Complete Blue Mcr Adv | $130.27 | — | — | 2026-05-09 | MRF ↗ |
| PENN HIGHLANDS CONNELLSVILLE Outpatient | Blue Cross | Community Blue Mcr Adv | $130.27 | — | — | 2026-05-09 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | United Healthcare | Commercial | $131.15 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Hfn | Commercial | $131.15 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Hfn | Commercial | $131.15 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | United Healthcare | Commercial | $131.15 | — | — | 2026-05-24 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - My Blue Access Ppo | $135.00 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Indemnity | $135.00 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Aca | $135.00 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - All Social Mission | $135.00 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Indemnity | $135.00 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS CONNELLSVILLE Outpatient | Traditional Medicare | Traditional Medicare | $135.00 | — | — | 2026-05-09 | MRF ↗ |
| PENN HIGHLANDS CONNELLSVILLE Outpatient | Geisinger | Mcr Advantage | $135.00 | — | — | 2026-05-09 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Managed Care | $135.00 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Performance Blue | $135.00 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Traditional Medicare | Traditional Medicare | $135.00 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Performance Blue | $135.00 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Aca | $135.00 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - All Social Mission | $135.00 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Traditional Medicare | Traditional Medicare | $135.00 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - My Blue Access Ppo | $135.00 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Managed Care | $135.00 | — | — | 2026-05-23 | MRF ↗ |
| FISHER-TITUS HOSPITAL Outpatient | Perennial Advantage | Perennial Advantage | $136.33 | — | — | 2026-05-27 | MRF ↗ |
| FISHER-TITUS HOSPITAL Outpatient | Optum | Vaccnoptum | $136.33 | — | — | 2026-05-27 | MRF ↗ |
| INTERMOUNTAIN HEALTH SPANISH FORK HOSPITAL Outpatient | Molina | Medicare Complete Care Hmo Snp | $137.44 | — | — | 2026-05-15 | MRF ↗ |
| CABELL HUNTINGTON HOSPITAL, INC Outpatient | Highmark Blue Cross | Medicare | $137.44 | — | — | 2026-05-14 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Molina | Medicare Choice Care Hmo | $137.44 | — | — | 2026-05-15 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Health Plan Of Nevada | Medicaid | $137.44 | — | — | 2026-05-14 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Selecthealth | Signature Individual Aca | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SPANISH FORK HOSPITAL Outpatient | Molina | Medicare Advantage | $137.44 | — | — | 2026-05-15 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Healthy U | Medicaid | $137.44 | — | — | 2026-05-15 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Selecthealth | Value Individual Aca | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Selecthealth | Medicare Advantage | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Selecthealth | Medicaid | $137.44 | — | — | 2026-05-14 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Uhc | Medicare Advantage | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Aetna | Medicare Adv Hmo | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Molina | Medicare Complete Care Hmo Snp | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Regence Bcbs | Medadvantage Ppo | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Molina | Medicaid | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Humana | Medicare Choice Ppo | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Humana | Medicare Choice Ppo | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Selecthealth | Medicaid | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Selecthealth | Med Individual Aca | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Southwest Behavioral Health | Behavioral Health | $137.44 | — | — | 2026-05-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Health Plan Of Nevada | Medicaid | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Regence Bcbs | Medadvantage Ppo | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Uhc | Medicare Advantage | $137.44 | — | — | 2026-05-14 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Molina | Medicare Advantage | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Molina | Medicare Choice Care Hmo | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Selecthealth | Medicaid | $137.44 | — | — | 2026-05-14 | MRF ↗ |
| CASSIA REGIONAL HOSPITAL Outpatient | Molina | Medicare Choice Care Hmo | $137.44 | — | — | 2026-05-15 | MRF ↗ |
| CASSIA REGIONAL HOSPITAL Outpatient | Molina | Medicare Complete Care Hmo Snp | $137.44 | — | — | 2026-05-15 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Health Partners Of Nevada | Medicare Advantage | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | American Health | Medicare Adv Ut Hmo I-Snp | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Aetna | Medicare Adv Ppo | $137.44 | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Selecthealth | Medicaid | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Aetna | Medicare Adv Hmo | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Health Plan Of Nevada | Medicaid | $137.44 | — | — | 2026-05-14 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Molina | Medicare Complete Care Hmo Snp | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Healthy U | Medicaid | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| CABELL HUNTINGTON HOSPITAL, INC Outpatient | Peia | Other Governmental | $137.44 | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Selecthealth | Medicare Advantage | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Aetna | Medicare Adv Ppo | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Selecthealth | Medicare Advantage | $137.44 | — | — | 2026-05-14 | MRF ↗ |
| CABELL HUNTINGTON HOSPITAL, INC Outpatient | Highmark Blue Cross | Ppo/Pos | $137.44 | — | — | 2026-05-14 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Humana | Medicare Choice Ppo | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Humana | Medicare Choice Ppo | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Aetna | Medicare Adv Hmo | $137.44 | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Regence Bcbs | Medadvantage Ppo | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Molina | Medicare Complete Care Hmo Snp | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Humana | Medicare Choice Ppo | $137.44 | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Uhc | Medicare Advantage | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Uhc | Medicare Advantage | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Molina | Medicaid | $137.44 | — | — | 2026-05-14 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Molina | Medicaid | $137.44 | — | — | 2026-05-13 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Molina | Medicare Advantage | $137.44 | — | — | 2026-05-13 | MRF ↗ |
| CABELL HUNTINGTON HOSPITAL, INC Outpatient | Humana | Medicare | $137.44 | — | — | 2026-05-14 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | American Health | Medicare Adv Ut Hmo I-Snp | $137.44 | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Selecthealth | Medicare Advantage | $137.44 | — | — | 2026-05-14 | MRF ↗ |
| CASSIA REGIONAL HOSPITAL Outpatient | Humana | Medicare Choice Ppo | $137.44 | — | — | 2026-05-15 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Aetna | Medicare Adv Ppo | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Aetna | Medicare Adv Ppo | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Aetna | Medicare Adv Ppo | $137.44 | — | — | 2026-05-14 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Aetna | Medicare Adv Hmo | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Health Partners Of Nevada | Medicare Advantage | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Molina | Medicaid | $137.44 | — | — | 2026-05-14 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Selecthealth | Medicare Advantage | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Molina | Medicaid | $137.44 | — | — | 2026-05-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Healthy U | Medicaid | $137.44 | — | — | 2026-05-14 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Aetna | Medicare Adv Hmo | $137.44 | — | — | 2026-05-14 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Molina | Medicare Complete Care Hmo Snp | $137.44 | — | — | 2026-05-15 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Uhc | Medicare Advantage | $137.44 | — | — | 2026-05-15 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Molina | Medicare Complete Care Hmo Snp | $137.44 | — | — | 2026-05-13 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Selecthealth | Medicaid | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Uhc | Medicare Advantage | $137.44 | — | — | 2026-05-14 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Health Plan Of Nevada | Medicaid | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Molina | Medicaid | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Molina | Medicare Choice Care Hmo | $137.44 | — | — | 2026-05-13 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | American Health | Medicare Adv Ut Hmo I-Snp | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Southwest Behavioral Health | Behavioral Health | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | American Health | Medicare Adv Ut Hmo I-Snp | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Health Partners Of Nevada | Medicare Advantage | $137.44 | — | — | 2026-05-14 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Health Partners Of Nevada | Medicare Advantage | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Health Partners Of Nevada | Medicare Advantage | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Molina | Medicare Choice Care Hmo | $137.44 | — | — | 2026-05-14 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Healthy U | Medicaid | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Health Plan Of Nevada | Medicaid | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SPANISH FORK HOSPITAL Outpatient | Health Partners Of Nevada | Medicare Advantage | $137.44 | — | — | 2026-05-15 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Regence Bcbs | Medadvantage Ppo | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Selecthealth | Medicaid | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Molina | Medicare Complete Care Hmo Snp | $137.44 | — | — | 2026-05-14 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Selecthealth | Med Individual Aca | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Healthy U | Medicaid | $137.44 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | American Health | Medicare Adv Ut Hmo I-Snp | $137.44 | — | — | 2026-05-14 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL Outpatient | Molina | Medicare Advantage | $137.44 | — | — | 2026-05-15 | 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.