66887000301 — Collagenase Clostrid Histolyt 0.9 Mg Ij Solr
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). COLLAGENASE CLOSTRID HISTOLYT 0.9 MG IJ SOLR (NDC 66887000301) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/66887000301?code_type=NDC
MLA (9th ed.)
“COLLAGENASE CLOSTRID HISTOLYT 0.9 MG IJ SOLR (NDC 66887000301) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/66887000301?code_type=NDC. Accessed .
Chicago (notes-bibliography)
“COLLAGENASE CLOSTRID HISTOLYT 0.9 MG IJ SOLR (NDC 66887000301) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/66887000301?code_type=NDC.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $6,678–$14,367 (25th–75th percentile) across 7 hospitals · 121 payers.
“Negotiated” is the hospital’s negotiated facility rate for this NDC 66887000301 — 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 HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | HAP | Self Insured | $2.10 | $22,805.54 | — | 2025-06-28 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | Aetna Medicare | Medicare | $41.35 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | Blue Shield | Medicare Advantage | $41.35 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | SCAN | Medicare | $52.45 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Anthem Vivity, Anthem HMO | HMO-NonCity of LA | $70.89 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Anthem Vivity-Anthem HMO | All Products-HMO | $70.89 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Monarch | Medicare | $71.16 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | UHC Mediare Advantage | Medicare Advantage | $71.16 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | LA Care DSNP | Medicare HMO | $71.16 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | LA care Medi-Cal HMO | Medi-Cal HMO | $72.21 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | TriWest Healthcare Alliance | Other Government | $75.74 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | UCLA Health Medicare Advantage Plan | Medicare Advantage | $75.74 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Aetna Medicare | Medicare | $75.74 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | TriWest Healthcare Alliance | Other Government | $75.74 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | UCLA Health Medicare Advantage Plan | Medicare Advantage | $75.74 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | St. Jude | Medicare HMO | $75.74 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Redlands Community Medicare | Medicare | $75.74 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Health Plan of Nevada Medicare | Medicare | $75.74 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Blue Shield | Medicare Advantage | $75.91 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | Blue Shield | All Products | $77.54 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Providence Healthcare | Medicare | $78.28 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Torrance Memorial Medicare | HMO-Medicare | $78.28 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Central Health Plan | Medicare HMO | $79.52 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Blue Shield | All Products | $83.70 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | Blue Shield | EPN | $83.70 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Blue Shield | EPN | $83.70 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | HealthSmart | Workers Compensation | $90.89 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | LA Care Covered CA | HMO | $92.78 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | SCAN | Medicare | $96.07 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Centivo | PPO | $181.78 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Health Plan of Nevada Commercial | All Products | $209.04 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Optum | Medicare | $217.37 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| HENRY COUNTY HEALTH CENTER OutpatientFacility | UNITED HEALTHCARE | ALL PRODUCTS | $3,604.32 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| HENRY COUNTY HEALTH CENTER OutpatientFacility | UNITED HEALTHCARE | ALL PRODUCTS | $3,604.32 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| HENRY COUNTY HEALTH CENTER OutpatientFacility | IOWA TOTAL CARE | ALL PRODUCTS | $3,679.41 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| HENRY COUNTY HEALTH CENTER OutpatientFacility | IOWA TOTAL CARE | ALL PRODUCTS | $3,679.41 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| HENRY COUNTY HEALTH CENTER OutpatientFacility | WELLPOINT (AMERIGROUP) | MANAGED MEDICAID | $4,205.04 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| HENRY COUNTY HEALTH CENTER OutpatientFacility | WELLPOINT (AMERIGROUP) | MANAGED MEDICAID | $4,205.04 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| SOUTHEAST IOWA REGIONAL MEDICAL CENTER OutpatientFacility | WELLPOINT (AMERIGROUP) | MANAGED MEDICAID | $4,205.04 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| HENRY COUNTY HEALTH CENTER OutpatientFacility | WELLMARK BLUE CROSS | MEDICARE ADV | $4,280.13 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| HENRY COUNTY HEALTH CENTER OutpatientFacility | HUMANA | HMO | $4,280.13 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| HENRY COUNTY HEALTH CENTER OutpatientFacility | HUMANA | PPO | $4,280.13 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| HENRY COUNTY HEALTH CENTER OutpatientFacility | AMERICAN HEALTH PLAN OF IOWA | MEDICARE ADV | $4,280.13 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| HENRY COUNTY HEALTH CENTER OutpatientFacility | WELLMARK BLUE CROSS | MEDICARE ADV | $4,280.13 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| HENRY COUNTY HEALTH CENTER OutpatientFacility | HUMANA | PPO | $4,280.13 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| HENRY COUNTY HEALTH CENTER OutpatientFacility | HUMANA | HMO | $4,280.13 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| HENRY COUNTY HEALTH CENTER OutpatientFacility | AMERICAN HEALTH PLAN OF IOWA | MEDICARE ADV | $4,280.13 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| SOUTHEAST IOWA REGIONAL MEDICAL CENTER OutpatientFacility | WELLMARK BLUE CROSS | MEDICARE ADV | $4,280.13 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| HENRY COUNTY HEALTH CENTER OutpatientFacility | MOLINA | MANAGED MEDICAID | $4,331.19 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| HENRY COUNTY HEALTH CENTER OutpatientFacility | MOLINA | MANAGED MEDICAID | $4,331.19 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| HENRY COUNTY HEALTH CENTER OutpatientFacility | AETNA | MEDICARE ADV | $4,505.40 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| HENRY COUNTY HEALTH CENTER OutpatientFacility | AETNA | MEDICARE ADV | $4,505.40 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| SOUTHEAST IOWA REGIONAL MEDICAL CENTER OutpatientFacility | MOLINA | MEDICARE ADV | $4,505.40 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| SOUTHEAST IOWA REGIONAL MEDICAL CENTER OutpatientFacility | MOLINA | ALL PRODUCTS | $4,505.40 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| HENRY COUNTY HEALTH CENTER BothFacility | IMMUGRUN | ALL PRODUCTS | $4,730.67 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| SOUTHEAST IOWA REGIONAL MEDICAL CENTER BothFacility | IMMUGRUN | ALL PRODUCTS | $4,730.67 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| HENRY COUNTY HEALTH CENTER BothFacility | IMMUGRUN | ALL PRODUCTS | $4,730.67 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| HENRY COUNTY HEALTH CENTER BothFacility | PLAIN CHURCH | ALL PRODUCTS | $4,880.85 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| SOUTHEAST IOWA REGIONAL MEDICAL CENTER BothFacility | PLAIN CHURCH | ALL PRODUCTS | $4,880.85 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| HENRY COUNTY HEALTH CENTER BothFacility | BRIGHTON AMISH CHURCH | ALL PRODUCTS | $4,880.85 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| HENRY COUNTY HEALTH CENTER BothFacility | PLAIN CHURCH | ALL PRODUCTS | $4,880.85 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| HENRY COUNTY HEALTH CENTER BothFacility | BRIGHTON AMISH CHURCH | ALL PRODUCTS | $4,880.85 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| SOUTHEAST IOWA REGIONAL MEDICAL CENTER BothFacility | BRIGHTON AMISH CHURCH | ALL PRODUCTS | $4,880.85 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| HENRY COUNTY HEALTH CENTER OutpatientFacility | ELAP | INNOVAIRE | $5,031.03 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| HENRY COUNTY HEALTH CENTER OutpatientFacility | ELAP | INNOVAIRE | $5,031.03 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Aetna Medicare | Medicare | $5,130.91 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | UCLA Health Medicare Advantage Plan | Medicare Advantage | $5,130.91 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SOUTHEAST IOWA REGIONAL MEDICAL CENTER OutpatientFacility | ABSOLUTE SOLUTIONS | ALL PRODUCTS | $5,256.30 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| SOUTHEAST IOWA REGIONAL MEDICAL CENTER OutpatientFacility | EBS NETWORK | ALL PRODUCTS | $5,631.75 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| HENRY COUNTY HEALTH CENTER BothFacility | MIDLANDS CHOICE | PREMIER | $5,744.39 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| HENRY COUNTY HEALTH CENTER BothFacility | MIDLANDS CHOICE | MEDICARE ADV | $5,744.39 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| HENRY COUNTY HEALTH CENTER BothFacility | MIDLANDS CHOICE | PREMIER | $5,744.39 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| SOUTHEAST IOWA REGIONAL MEDICAL CENTER BothFacility | MIDLANDS CHOICE | PREMIER | $5,744.39 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| SOUTHEAST IOWA REGIONAL MEDICAL CENTER BothFacility | MIDLANDS CHOICE | MEDICARE ADV | $5,744.39 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| HENRY COUNTY HEALTH CENTER BothFacility | MIDLANDS CHOICE | MEDICARE ADV | $5,744.39 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Gold Coast Health Plan | HMO | $5,746.62 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Gold Coast Health Plan | HMO | $5,746.62 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Anthem Workers Comp | Workers Comp | $5,888.23 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SOUTHEAST IOWA REGIONAL MEDICAL CENTER BothFacility | 6 DEGREE | ALL PRODUCTS | $6,007.20 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| HENRY COUNTY HEALTH CENTER BothFacility | 6 DEGREE | ALL PRODUCTS | $6,007.20 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| HENRY COUNTY HEALTH CENTER BothFacility | 6 DEGREE | ALL PRODUCTS | $6,007.20 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | Anthem Vivity, Anthem HMO | HMO-City of LA | $6,015.48 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SOUTHEAST IOWA REGIONAL MEDICAL CENTER BothFacility | UNITED HEALTHCARE | ALL PRODUCTS | $6,382.65 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| HENRY COUNTY HEALTH CENTER BothFacility | MIDLANDS CHOICE | ALL PRODUCTS | $6,382.65 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| HENRY COUNTY HEALTH CENTER BothFacility | MIDLANDS CHOICE | ALL PRODUCTS | $6,382.65 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| SOUTHEAST IOWA REGIONAL MEDICAL CENTER BothFacility | MIDLANDS CHOICE | ALL PRODUCTS | $6,382.65 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Anthem Vivity, Anthem HMO | HMO-City of LA | $6,674.28 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SOUTHEAST IOWA REGIONAL MEDICAL CENTER OutpatientFacility | AETNA | ALL PRODUCTS | $6,690.52 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | UC Care - PPO | PPO | $6,731.75 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| HENRY COUNTY HEALTH CENTER InpatientFacility | MIDLANDS CHOICE | ALL PRODUCTS | $6,758.10 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| HENRY COUNTY HEALTH CENTER InpatientFacility | MIDLANDS CHOICE | ALL PRODUCTS | $6,758.10 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| SOUTHEAST IOWA REGIONAL MEDICAL CENTER BothFacility | HEALTH SMART | ALL PRODUCTS | $6,758.10 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| SOUTHEAST IOWA REGIONAL MEDICAL CENTER InpatientFacility | MIDLANDS CHOICE | ALL PRODUCTS | $6,758.10 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | Molina MI Health Link | MEDICARE ADVANTAGE | $6,841.66 | $22,805.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | Molina MI Health Link | MEDICARE ADVANTAGE | $6,841.66 | $22,805.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | MOLINA | MARKETPLACE | $6,841.66 | $22,805.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | WellCare | Medicare Advantage | $6,887.27 | $22,805.54 | — | 2025-06-28 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | UC Ship | PPO | $6,895.94 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | UC Ship | PPO | $6,895.94 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SOUTHEAST IOWA REGIONAL MEDICAL CENTER OutpatientFacility | CARE FOR YOURSELF | MEDICARE ADV | $7,133.55 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| SOUTHEAST IOWA REGIONAL MEDICAL CENTER BothFacility | MULTIPLAN | ALL PRODUCTS | $7,133.55 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| SOUTHEAST IOWA REGIONAL MEDICAL CENTER BothFacility | HENDERSON COUNTY | ALL PRODUCTS | $7,133.55 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| SOUTHEAST IOWA REGIONAL MEDICAL CENTER OutpatientFacility | IOWA TOTAL CARE | MEDICARE ADV | $7,133.55 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| SOUTHEAST IOWA REGIONAL MEDICAL CENTER BothFacility | ACCOUNTABLE HEALTH PLANS | ALL PRODUCTS | $7,133.55 | $7,509.00 | — | 2025-06-04 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Blue Shield | Medicare Advantage | $7,183.27 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Health Care LA - RMG | All Products | $7,183.27 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | CenCal Medi-Cal HMO | Medi-Cal HMO | $7,183.27 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Health Care LA MediCal - RMG | Medicaid Advantage | $7,183.27 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Providence Healthcare | Medicare | $7,183.27 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Health Care LA MediCal - RMG | Medicaid Advantage | $7,183.27 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Health Care LA - RMG | All Products | $7,183.27 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | CenCal Transplant Medi-Cal HMO | Medi-Cal HMO | $7,183.27 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Anthem Vivity, Anthem HMO | HMO-NonCity of LA | $7,519.86 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | Anthem Vivity, Anthem HMO | HMO-NonCity of LA | $7,519.86 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | UC Care - PPO | PPO | $8,024.74 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | UCI University - RMG | All Products | $8,209.45 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Molina Healthcare HMO | MediCal HMO | $8,209.45 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | UCI University - RMG | All Products | $8,209.45 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Children Hospital of Orange County | Medicaid HMO | $8,209.45 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Molina Healthcare HMO | MediCal HMO | $8,209.45 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Children Hospital of Orange County | Medicaid HMO | $8,209.45 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | LA care Medi-Cal HMO | Medi-Cal HMO | $8,209.45 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | UC Ship | PPO | $8,291.55 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | UC Ship | PPO | $8,291.55 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | UC Ship | PPO | $9,748.72 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Kaiser | All Products | $10,364.43 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Kaiser | Medicare | $10,364.43 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Kaiser | All Products | $10,364.43 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Kaiser | Medicare | $10,364.43 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | HealthCare Partners HMO | HMO-Medicare | $11,288.00 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | LA Care Covered CA | HMO | $11,288.00 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | HealthCare Partners HMO | HMO-Medicare | $11,288.00 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | LA Care DSNP | Medicare HMO | $11,288.00 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Optum | Medicare | $11,288.00 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | VitalCore Physicians Group of MI | All Products | $11,402.77 | $22,805.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | VitalCore Physicians Group of MI | All Products | $11,402.77 | $22,805.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH BothFacility | McLaren Health | Commercial HMO | $11,452.94 | $22,805.54 | — | 2025-06-28 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Health Net B&G | HMO | $11,472.71 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Kaiser | All Products | $11,493.23 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Kaiser | All Products | $11,493.23 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | Kaiser | All Products | $11,698.47 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | HAP | Fully Insured | $11,820.11 | $22,805.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH BothFacility | Jackson County Offiice of the Sheriff | Jackson County Jail | $11,858.88 | $22,805.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | NFL Health Services - Cigna | ALL PRODUCTS | $11,858.88 | $22,805.54 | — | 2025-06-28 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Redlands Community General Services | HMO | $11,903.71 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Redlands Community General Services | HMO | $11,903.71 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Blue Shield | EPN | $11,961.00 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Cigna | HMO | $12,008.38 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Cigna | PPO | $12,008.38 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Cigna | PPO | $12,008.38 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Cigna | HMO | $12,008.38 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL BothFacility | Priority Health | HMO/PPO | $12,527.08 | $22,805.54 | — | 2025-06-28 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Health Plan of Nevada Commercial | All Products | $13,135.12 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL BothFacility | McLaren Health | Commercial HMO | $13,158.80 | $22,805.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL BothFacility | McLaren Health | Health Advantage PPO | $13,158.80 | $22,805.54 | — | 2025-06-28 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Santa Barbara Select IPA - RMG | All Products | $13,340.36 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Santa Barbara Select IPA - RMG | All Products | $13,340.36 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Seaview IPA - RMG | All Products | $13,340.36 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Monarch | Medicare | $13,340.36 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Seoul Medical Group - RMG | All Products | $13,340.36 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | MemorialCare Medical Foundation - RMG | All Products | $13,340.36 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Primecare Commercial | HMO | $13,340.36 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Torrance Hospital - RMG | All Products | $13,340.36 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Valley Care - RMG | All Products | $13,340.36 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Access Medical Group - RMG | All Products | $13,340.36 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Western Neurological Network - RMG | All Products | $13,340.36 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Primecare Commercial | HMO | $13,340.36 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Valley Care - RMG | All Products | $13,340.36 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Western Neurological Network - RMG | All Products | $13,340.36 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Access Medical Group - RMG | All Products | $13,340.36 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Monarch | Medicare | $13,340.36 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Torrance Hospital - RMG | All Products | $13,340.36 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Seoul Medical Group - RMG | All Products | $13,340.36 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Seaview IPA - RMG | All Products | $13,340.36 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | MemorialCare Medical Foundation - RMG | All Products | $13,340.36 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | Immergrun Inc | ALL PRODUCTS | $13,683.32 | $22,805.54 | — | 2025-06-28 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Aetna | All Products | $13,915.02 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Aetna | All Products | $13,915.02 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | Aetna | All Products | $13,915.02 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | UHC Select/SelectPlus | Select-Select Plus | $14,054.58 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | UHC Select/SelectPlus | Select-Select Plus | $14,054.58 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | First Health | Workers Compensation | $14,079.21 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | HAP | HMO/AHL | $14,139.43 | $22,805.54 | — | 2025-06-28 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | UHC Select/SelectPlus | Select-Select Plus | $14,241.35 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | UHC Select/SelectPlus | Select-Select Plus | $14,241.35 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Health Net B&G | HMO | $14,243.40 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Health Net B&G | HMO | $14,243.40 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | AETNA | ALL PRODUCTS | $14,253.46 | $22,805.54 | — | 2025-06-28 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Primecare Transplant | HMO | $14,366.54 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Redlands Yucaipa Medical Group - RMG | All Products | $14,366.54 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Riverside Medical Clinic - RMG | All Products | $14,366.54 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Saint Johns - RMG | All Products | $14,366.54 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | San Bernardino - RMG | All Products | $14,366.54 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Sansum Clinic - RMG | All Products | $14,366.54 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Sharp Rees-Stealy - RMG | All Products | $14,366.54 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | St Joseph Heritage - RMG | All Products | $14,366.54 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | St Mary IPA - RMG | All Products | $14,366.54 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | St Vincent IPA - RMG | All Products | $14,366.54 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | St. Jude | All Products | $14,366.54 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Tri Valley - RMG | All Products | $14,366.54 | $20,523.63 | $11,288.00 | 2026-03-29 | MRF ↗ |
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