66919 — Levetiracetam
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). LEVETIRACETAM (HCPCS 66919) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/66919?code_type=HCPCS
MLA (9th ed.)
“LEVETIRACETAM (HCPCS 66919) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/66919?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“LEVETIRACETAM (HCPCS 66919) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/66919?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $17–$246 (25th–75th percentile) across 5 hospitals · 32 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 66919 — 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 |
|---|---|---|---|---|---|---|---|
| ACMH HOSPITAL Outpatient | Highmark | Highmark Mcr Freedom Blue | $11.96 | $122.00 | $36.60 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Highmark | Highmark Mcr Freedom Blue | $11.96 | $122.00 | $36.60 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Tricare | Tricare | $12.30 | $122.00 | $36.60 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Tricare | Tricare | $12.30 | $122.00 | $36.60 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Highmark | Highmark Mcr Community/Complete Blue | $12.33 | $122.00 | $36.60 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Highmark | Highmark Mcr Community/Complete Blue | $12.33 | $122.00 | $36.60 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Upmc Health Plan | Upmc Medicare | $12.98 | $122.00 | $36.60 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Unitedhealthcare Insurance Company | United Medicare | $12.98 | $122.00 | $36.60 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Aetna | Aetna Medicare | $12.98 | $122.00 | $36.60 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Upmc Health Plan | Upmc Medicare | $12.98 | $122.00 | $36.60 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Aetna | Aetna Medicare | $12.98 | $122.00 | $36.60 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Unitedhealthcare Insurance Company | United Medicare | $12.98 | $122.00 | $36.60 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Centene Corporation | Pa H And W Medicare | $13.11 | $122.00 | $36.60 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Centene Corporation | Pa H And W Medicare | $13.11 | $122.00 | $36.60 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Geisinger Medicare | Geisinger Medicare | $13.24 | $122.00 | $36.60 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Geisinger Medicare | Geisinger Medicare | $13.24 | $122.00 | $36.60 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Unitedhealthcare Insurance Company | Va Ccn Optum | $13.25 | $122.00 | $36.60 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Umwa | Umwa | $13.25 | $122.00 | $36.60 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Highmark | Highmark Wholecare Medicare | $13.25 | $122.00 | $36.60 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Unitedhealthcare Insurance Company | Va Ccn Optum | $13.25 | $122.00 | $36.60 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Highmark | Highmark Wholecare Medicare | $13.25 | $122.00 | $36.60 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Umwa | Umwa | $13.25 | $122.00 | $36.60 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Amerihealth Caritas Medicare | Amerihealth Caritas Medicare | $13.52 | $122.00 | $36.60 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Amerihealth Caritas Medicare | Amerihealth Caritas Medicare | $13.52 | $122.00 | $36.60 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Highmark | Highmark Mcr Security Blue | $14.01 | $122.00 | $36.60 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Highmark | Highmark Mcr Security Blue | $14.01 | $122.00 | $36.60 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Amerihealth Caritas | Amerihealth Caritas Medicaid | $14.47 | $122.00 | $36.60 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Amerihealth Caritas | Amerihealth Caritas Medicaid | $14.47 | $122.00 | $36.60 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Centene Corporation | Pa H And W Medicaid | $15.92 | $122.00 | $36.60 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Centene Corporation | Pa H And W Medicaid | $15.92 | $122.00 | $36.60 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Highmark | Highmark Chip / Social Mission | $16.01 | $122.00 | $36.60 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Highmark | Highmark Chip / Social Mission | $16.01 | $122.00 | $36.60 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Pa Health And Wellness Commercial | Pa Health And Wellness Commercial | $16.56 | $122.00 | $36.60 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Pa Health And Wellness Commercial | Pa Health And Wellness Commercial | $16.56 | $122.00 | $36.60 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Upmc Health Plan | Upmc Medicaid | $16.71 | $122.00 | $36.60 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Upmc Health Plan | Upmc Medicaid | $16.71 | $122.00 | $36.60 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | United Medicaid | United Medicaid | $17.36 | $122.00 | $36.60 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | United Chip | United Chip | $17.36 | $122.00 | $36.60 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | United Chip | United Chip | $17.36 | $122.00 | $36.60 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | United Medicaid | United Medicaid | $17.36 | $122.00 | $36.60 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Geisinger | Geisinger | $18.55 | $122.00 | $36.60 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Geisinger | Geisinger | $18.55 | $122.00 | $36.60 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | The Health Plan Commercial | The Health Plan Commercial | $18.55 | $122.00 | $36.60 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | The Health Plan Commercial | The Health Plan Commercial | $18.55 | $122.00 | $36.60 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Geisinger Medicaid | Geisinger Medicaid | $19.10 | $122.00 | $36.60 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Geisinger Medicaid | Geisinger Medicaid | $19.10 | $122.00 | $36.60 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Pa Health And Wellness Commercial | Pa Health And Wellness Commercial | $26.50 | $122.00 | $36.60 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Pa Health And Wellness Commercial | Pa Health And Wellness Commercial | $26.50 | $122.00 | $36.60 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Highmark | Highmark Aca / My Direct Blue / My Blue Access Ppo | $31.03 | $122.00 | $36.60 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Highmark | Highmark Aca / My Direct Blue / My Blue Access Ppo | $31.03 | $122.00 | $36.60 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Highmark | Highmark Comm Community Blue | $31.62 | $122.00 | $36.60 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Highmark | Highmark Comm Community Blue | $31.62 | $122.00 | $36.60 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Unitedhealthcare Insurance Company | United | $33.13 | $122.00 | $36.60 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Unitedhealthcare Insurance Company | United | $33.13 | $122.00 | $36.60 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Highmark | Highmark Comm Managed/Indemnity | $33.73 | $122.00 | $36.60 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Highmark | Highmark Comm Managed/Indemnity | $33.73 | $122.00 | $36.60 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Geisinger | Geisinger | $37.10 | $122.00 | $36.60 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Geisinger | Geisinger | $37.10 | $122.00 | $36.60 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | The Health Plan Commercial | The Health Plan Commercial | $37.10 | $122.00 | $36.60 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | The Health Plan Commercial | The Health Plan Commercial | $37.10 | $122.00 | $36.60 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Aetna | Aetna | $42.14 | $122.00 | $36.60 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Aetna | Aetna | $42.14 | $122.00 | $36.60 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Upmc Chip | Upmc Chip | $42.70 | $122.00 | $36.60 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Upmc Chip | Upmc Chip | $42.70 | $122.00 | $36.60 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Carelon/Beacon Beahvioral Health | Carelon/Beacon Behavioral Health | $61.00 | $122.00 | $36.60 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Carelon/Beacon Beahvioral Health | Carelon/Beacon Behavioral Health | $61.00 | $122.00 | $36.60 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Cigna | Cigna | $65.88 | $122.00 | $36.60 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Cigna | Cigna | $65.88 | $122.00 | $36.60 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Upmc Health Plan | Upmc | $87.73 | $122.00 | $36.60 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Upmc Health Plan | Upmc | $87.73 | $122.00 | $36.60 | 2026-05-14 | MRF ↗ |
| THE UNIVERSITY OF VERMONT HEALTH NETWORK-ALICE HY Both | Cdphp | Commercial | — | $300.00 | $300.00 | 2026-05-09 | MRF ↗ |
| THE UNIVERSITY OF VERMONT HEALTH NETWORK-ALICE HY Both | Cdphp | Medicareadvantage | — | $300.00 | $300.00 | 2026-05-09 | MRF ↗ |
| THE UNIVERSITY OF VERMONT HEALTH NETWORK-ALICE HY Both | Mvp | Smlggroup | — | $300.00 | $300.00 | 2026-05-09 | MRF ↗ |
| THE UNIVERSITY OF VERMONT HEALTH NETWORK-ALICE HY Both | Mvp | Medicareadvantage | — | $300.00 | $300.00 | 2026-05-09 | MRF ↗ |
| THE UNIVERSITY OF VERMONT HEALTH NETWORK-ALICE HY Both | Humanamilitary | Tricare | — | $300.00 | $300.00 | 2026-05-09 | MRF ↗ |
| THE UNIVERSITY OF VERMONT HEALTH NETWORK-ALICE HY Both | Choicecare | Commercial | — | $300.00 | $300.00 | 2026-05-09 | MRF ↗ |
| THE UNIVERSITY OF VERMONT HEALTH NETWORK-ALICE HY Both | Humana | Medicareadvantage | — | $300.00 | $300.00 | 2026-05-09 | MRF ↗ |
| THE UNIVERSITY OF VERMONT HEALTH NETWORK-ALICE HY Both | Humana | Commercial | — | $300.00 | $300.00 | 2026-05-09 | MRF ↗ |
| THE UNIVERSITY OF VERMONT HEALTH NETWORK-ALICE HY Both | Fidelis | Medicareadvantage | — | $300.00 | $300.00 | 2026-05-09 | MRF ↗ |
| THE UNIVERSITY OF VERMONT HEALTH NETWORK-ALICE HY Both | Choicecare | Medicareadvantage | — | $300.00 | $300.00 | 2026-05-09 | MRF ↗ |
| THE UNIVERSITY OF VERMONT HEALTH NETWORK-ALICE HY Both | Aetna | Commercial | — | $300.00 | $300.00 | 2026-05-09 | MRF ↗ |
| THE UNIVERSITY OF VERMONT HEALTH NETWORK-ALICE HY Both | Aetna | Medicareadvantage | — | $300.00 | $300.00 | 2026-05-09 | MRF ↗ |
| THE UNIVERSITY OF VERMONT HEALTH NETWORK-ALICE HY Both | Mvp | Individual | — | $300.00 | $300.00 | 2026-05-09 | MRF ↗ |
| THE UNIVERSITY OF VERMONT HEALTH NETWORK-ALICE HY Both | United | Medicareadvantage | — | $300.00 | $300.00 | 2026-05-09 | MRF ↗ |
| THE UNIVERSITY OF VERMONT HEALTH NETWORK-ALICE HY Both | Martinspoint | Tricare | — | $300.00 | $300.00 | 2026-05-09 | MRF ↗ |
| THE UNIVERSITY OF VERMONT HEALTH NETWORK-ALICE HY Both | Magnacare | — | — | $300.00 | $300.00 | 2026-05-09 | MRF ↗ |
| ACMH HOSPITAL Inpatient | Multiplan | Multiplan | $109.80 | $122.00 | $36.60 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Multiplan | Multiplan | $109.80 | $122.00 | $36.60 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Multiplan | Multiplan | $109.80 | $122.00 | $36.60 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Inpatient | Multiplan | Multiplan | $109.80 | $122.00 | $36.60 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Pa Workers' Compensation | Pa Workers Compensation | $122.00 | $122.00 | $36.60 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Highmark | Highmark Mcr Snf Episodic Bundle | $122.00 | $122.00 | $36.60 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Pa Workers' Compensation | Pa Workers Compensation | $122.00 | $122.00 | $36.60 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Highmark | Highmark Mcr Snf Episodic Bundle | $122.00 | $122.00 | $36.60 | 2026-05-14 | MRF ↗ |
| CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CTR Both | Humanamilitary | Tricare | $187.31 | $312.18 | — | 2026-05-13 | MRF ↗ |
| CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CTR Both | Humanamilitary | Tricare | $187.31 | $312.18 | — | 2026-05-23 | MRF ↗ |
| CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CTR Both | Aetna | Commercial | $212.28 | $312.18 | — | 2026-05-23 | MRF ↗ |
| CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CTR Both | Aetna | Commercial | $212.28 | $312.18 | — | 2026-05-13 | MRF ↗ |
| CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CTR Both | Highmark | — | $231.01 | $312.18 | — | 2026-05-23 | MRF ↗ |
| CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CTR Both | Highmark | — | $231.01 | $312.18 | — | 2026-05-13 | MRF ↗ |
| CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CTR Both | United | Commercial | $238.35 | $312.18 | — | 2026-05-23 | MRF ↗ |
| CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CTR Both | United | Commercial | $238.35 | $312.18 | — | 2026-05-13 | MRF ↗ |
| CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CTR Both | Cdphp | Commercial | $246.00 | $312.18 | — | 2026-05-23 | MRF ↗ |
| CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CTR Both | Cdphp | Commercial | $246.00 | $312.18 | — | 2026-05-13 | MRF ↗ |
| CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CTR Both | Mvp | Commercial | $246.75 | $312.18 | — | 2026-05-13 | MRF ↗ |
| CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CTR Both | Mvp | Commercial | $246.75 | $312.18 | — | 2026-05-23 | MRF ↗ |
| CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CTR Both | Multiplan | — | $249.74 | $312.18 | — | 2026-05-23 | MRF ↗ |
| CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CTR Both | Harvardpilgrim | — | $249.74 | $312.18 | — | 2026-05-23 | MRF ↗ |
| CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CTR Both | Emblemghi | — | $249.74 | $312.18 | — | 2026-05-23 | MRF ↗ |
| CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CTR Both | Emblemghi | — | $249.74 | $312.18 | — | 2026-05-13 | MRF ↗ |
| CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CTR Both | Multiplan | — | $249.74 | $312.18 | — | 2026-05-13 | MRF ↗ |
| CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CTR Both | Magnacare | — | $249.74 | $312.18 | — | 2026-05-13 | MRF ↗ |
| CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CTR Both | Harvardpilgrim | — | $249.74 | $312.18 | — | 2026-05-13 | MRF ↗ |
| CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CTR Both | Magnacare | — | $249.74 | $312.18 | — | 2026-05-23 | MRF ↗ |
| CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CTR Both | Threeriversprovidernetwork | — | $265.35 | $312.18 | — | 2026-05-23 | MRF ↗ |
| CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CTR Both | Threeriversprovidernetwork | — | $265.35 | $312.18 | — | 2026-05-13 | MRF ↗ |
| CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CTR Both | Coventry | — | $280.96 | $312.18 | — | 2026-05-23 | MRF ↗ |
| CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CTR Both | Coventry | — | $280.96 | $312.18 | — | 2026-05-13 | MRF ↗ |
| CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CTR Both | Martinspoint | Tricare | $312.18 | $312.18 | — | 2026-05-23 | MRF ↗ |
| CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CTR Both | Martinspoint | Tricare | $312.18 | $312.18 | — | 2026-05-13 | MRF ↗ |
| DENVER HEALTH & HOSPITAL AUTHORITY OutpatientFacility | United Healthcare | HMO/POS/PPO | $4,344.00 | — | — | 2026-04-30 | MRF ↗ |
| COMMUNITY HOSPITAL OutpatientFacility | LAW ENFORCEMENT | MANAGED MEDICAID | $5,170.88 | $9,944.00 | $8,949.60 | 2025-12-27 | MRF ↗ |
| COMMUNITY HOSPITAL OutpatientFacility | NEBRASKA TOTAL CARE | MANAGED MEDICAID | $5,170.88 | $9,944.00 | $8,949.60 | 2025-12-27 | MRF ↗ |
| COMMUNITY HOSPITAL OutpatientFacility | HEALTHY BLUE | MANAGED MEDICAID | $5,170.88 | $9,944.00 | $8,949.60 | 2025-12-27 | MRF ↗ |
| COMMUNITY HOSPITAL OutpatientFacility | LAW ENFORCEMENT | MANAGED MEDICAID | $5,170.88 | $9,944.00 | $8,949.60 | 2025-12-27 | MRF ↗ |
| COMMUNITY HOSPITAL OutpatientFacility | UHC COMMUNITY PLAN NE | MANAGED MEDICAID | $5,170.88 | $9,944.00 | $8,949.60 | 2025-12-27 | MRF ↗ |
| COMMUNITY HOSPITAL OutpatientFacility | UHC COMMUNITY PLAN NE | MANAGED MEDICAID | $5,170.88 | $9,944.00 | $8,949.60 | 2025-12-27 | MRF ↗ |
| COMMUNITY HOSPITAL OutpatientFacility | NEBRASKA TOTAL CARE | MANAGED MEDICAID | $5,170.88 | $9,944.00 | $8,949.60 | 2025-12-27 | MRF ↗ |
| COMMUNITY HOSPITAL OutpatientFacility | HEALTHY BLUE | MANAGED MEDICAID | $5,170.88 | $9,944.00 | $8,949.60 | 2025-12-27 | MRF ↗ |
| COMMUNITY HOSPITAL BothFacility | BLUE CROSS | PPO | $9,446.80 | $9,944.00 | $8,949.60 | 2025-12-27 | MRF ↗ |
| COMMUNITY HOSPITAL BothFacility | BLUE CROSS | PPO | $9,446.80 | $9,944.00 | $8,949.60 | 2025-12-27 | MRF ↗ |
| COMMUNITY HOSPITAL BothFacility | NE WORKERS COMP | NE WORKERS COMP | $9,546.24 | $9,944.00 | $8,949.60 | 2025-12-27 | MRF ↗ |
| COMMUNITY HOSPITAL BothFacility | AETNA | PPO | $9,546.24 | $9,944.00 | $8,949.60 | 2025-12-27 | MRF ↗ |
| COMMUNITY HOSPITAL BothFacility | UHC | PPO | $9,546.24 | $9,944.00 | $8,949.60 | 2025-12-27 | MRF ↗ |
| COMMUNITY HOSPITAL BothFacility | MIDLANDS CHOICE | PPO | $9,546.24 | $9,944.00 | $8,949.60 | 2025-12-27 | MRF ↗ |
| COMMUNITY HOSPITAL BothFacility | NE WORKERS COMP | NE WORKERS COMP | $9,546.24 | $9,944.00 | $8,949.60 | 2025-12-27 | MRF ↗ |
| COMMUNITY HOSPITAL BothFacility | MIDLANDS CHOICE | PPO | $9,546.24 | $9,944.00 | $8,949.60 | 2025-12-27 | MRF ↗ |
| COMMUNITY HOSPITAL BothFacility | UHC | PPO | $9,546.24 | $9,944.00 | $8,949.60 | 2025-12-27 | MRF ↗ |
| COMMUNITY HOSPITAL BothFacility | AETNA | PPO | $9,546.24 | $9,944.00 | $8,949.60 | 2025-12-27 | MRF ↗ |