67457067502 — Levetiracetam 500 Mg Po Tabs
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). LEVETIRACETAM 500 MG PO TABS (NDC 67457067502) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/67457067502?code_type=NDC
MLA (9th ed.)
“LEVETIRACETAM 500 MG PO TABS (NDC 67457067502) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/67457067502?code_type=NDC. Accessed .
Chicago (notes-bibliography)
“LEVETIRACETAM 500 MG PO TABS (NDC 67457067502) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/67457067502?code_type=NDC.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $9–$7,009 (25th–75th percentile) across 35 hospitals · 215 payers.
“Negotiated” is the hospital’s negotiated facility rate for this NDC 67457067502 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.
Per-month price trends are temporarily unavailable while we rebuild them on quality-filtered rates. The medians, percentiles, and per-hospital rates on this page are the quality-filtered figures.
Hospital rates (per row)
Showing consumer-grade rates only. Flagged / outlier filings (excluded from the medians above) are hidden — tick “Show flagged / outlier rates” to include them.
| Hospital | Payer | Plan | Negotiated rate | Gross | Cash | Observed | Source |
|---|---|---|---|---|---|---|---|
| WYANDOTTE HOSPITAL AND MEDICAL CENTER InpatientFacility | UHC | ALL PRODUCTS | $0.38 | $9,401.30 | — | 2025-06-28 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL BothFacility | PROVIDENCE | MA-BEHAVIORAL HEALTH | $0.58 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL BothFacility | PROVIDENCE | MEDICARE ADV. | $0.58 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL OutpatientFacility | SAMARITAN | MEDICARE ADV. | $0.59 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | Healthfirst | MEDICARE ADVANTAGE | $0.60 | $3.00 | — | 2026-09-05 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | Healthfirst | Medicare Advantage PPO | $0.60 | $3.00 | — | 2026-09-05 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | Healthfirst | MAP | $0.60 | $3.00 | — | 2026-09-05 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | Healthfirst | Small Group | $0.60 | $3.00 | — | 2026-09-05 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL OutpatientFacility | REGENCE | MEDICARE ADV. | $0.64 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL OutpatientFacility | HEALTHNET | MEDICARE ADV. | $0.64 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL OutpatientFacility | PACIFICSOURCE | MEDICARE ADV. | $0.65 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | PROVIDENCE | MEDICARE ADV. | $0.66 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | PROVIDENCE | MEDICARE ADV. | $0.66 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL OutpatientFacility | DEVOTED HEALTH | DEVOTED HEALTH MCR ADVANTAGE | $0.67 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | HUMANA | MEDICARE ADV. | $0.67 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | SAMARITAN | MEDICARE ADV. | $0.67 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | HUMANA | MEDICARE ADV. | $0.67 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | SAMARITAN | MEDICARE ADV. | $0.67 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL OutpatientFacility | PROVIDENCE | MEDICARE ADV. | $0.72 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | REGENCE | MEDICARE ADV. | $0.73 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | REGENCE | MEDICARE ADV. | $0.73 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL OutpatientFacility | SAMARITAN | MEDICARE ADV. | $0.73 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | PACIFICSOURCE | MEDICARE ADV. | $0.74 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | PACIFICSOURCE | MEDICARE ADV. | $0.74 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | Healthfirst | EXCHANGE | $0.75 | $3.00 | — | 2026-09-05 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | DEVOTED HEALTH | DEVOTED HEALTH MCR ADVANTAGE | $0.76 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | DEVOTED HEALTH | DEVOTED HEALTH MCR ADVANTAGE | $0.76 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL OutpatientFacility | REGENCE | MEDICARE ADV. | $0.79 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL OutpatientFacility | PACIFICSOURCE | MEDICARE ADV. | $0.81 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL OutpatientFacility | DEVOTED HEALTH | DEVOTED HEALTH MCR ADVANTAGE | $0.83 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN ALBANY GENERAL HOSPITAL OutpatientFacility | SAMARITAN | MEDICARE ADV. | $1.00 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| GOOD SAMARITAN REGIONAL MEDICAL CENTER OutpatientFacility | SAMARITAN | MEDICARE ADV. | $1.00 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | Aetna | MEDICARE ADVANTAGE | $1.20 | $3.00 | — | 2026-09-05 | MRF ↗ |
| GOOD SAMARITAN REGIONAL MEDICAL CENTER OutpatientFacility | PROVIDENCE | MEDICARE ADV. | $1.34 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN ALBANY GENERAL HOSPITAL OutpatientFacility | PROVIDENCE | MEDICARE ADV. | $1.34 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | SAMARITAN | EPO | $1.40 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL BothFacility | SAMARITAN | EPO | $1.40 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | SAMARITAN | EPO | $1.40 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL BothFacility | SAMARITAN | EPO | $1.40 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| GOOD SAMARITAN REGIONAL MEDICAL CENTER OutpatientFacility | PACIFICSOURCE | MEDICARE ADV. | $1.40 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | Centerlight | PACE | $1.50 | $3.00 | — | 2026-09-05 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | OXFORD | Liberty | $1.50 | $3.00 | — | 2026-09-05 | MRF ↗ |
| SAMARITAN ALBANY GENERAL HOSPITAL BothFacility | SAMARITAN | SAMARITAN CHOICE | $1.60 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL BothFacility | SAMARITAN | SAMARITAN CHOICE | $1.60 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | SAMARITAN | SAMARITAN CHOICE | $1.60 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | SAMARITAN | SAMARITAN CHOICE | $1.60 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| GOOD SAMARITAN REGIONAL MEDICAL CENTER BothFacility | SAMARITAN | SAMARITAN CHOICE | $1.60 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL BothFacility | SAMARITAN | SAMARITAN CHOICE | $1.60 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | OSCAR | ALL PRODUCTS | $1.65 | $3.00 | — | 2026-09-05 | MRF ↗ |
| GOOD SAMARITAN REGIONAL MEDICAL CENTER BothFacility | REGENCE | ALL PRODUCTS | $1.68 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN ALBANY GENERAL HOSPITAL BothFacility | REGENCE | ALL PRODUCTS | $1.68 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL BothFacility | SAMARITAN | SAMARITAN GROUP | $1.70 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL BothFacility | SAMARITAN | SAMARITAN GROUP | $1.70 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | SAMARITAN | SAMARITAN GROUP | $1.70 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | SAMARITAN | SAMARITAN GROUP | $1.70 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | EMBLEM | Essential Plan 3-4 | $1.80 | $3.00 | — | 2026-09-05 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL BothFacility | REGENCE | ALL PRODUCTS | $1.80 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | REGENCE | ALL PRODUCTS | $1.80 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | REGENCE | ALL PRODUCTS | $1.80 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | OXFORD | Freedom | $1.80 | $3.00 | — | 2026-09-05 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL BothFacility | REGENCE | ALL PRODUCTS | $1.80 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | Wellcare | MEDICARE ADVANTAGE | $1.80 | $3.00 | — | 2026-09-05 | MRF ↗ |
| GOOD SAMARITAN REGIONAL MEDICAL CENTER OutpatientFacility | PROVIDENCE | INDIVIDUAL-STANDARD | $1.88 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | MODA | CONNEXUS-SYNERGY-OHSU PPO | $1.90 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | AETNA | ALL PRODUCTS | $1.90 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN ALBANY GENERAL HOSPITAL BothFacility | AETNA | ALL PRODUCTS | $1.90 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN ALBANY GENERAL HOSPITAL BothFacility | CIGNA | ALL PRODUCTS | $1.90 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | AETNA | ALL PRODUCTS | $1.90 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | MODA | CONNEXUS-SYNERGY-OHSU PPO | $1.90 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL BothFacility | AETNA | ALL PRODUCTS | $1.90 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL BothFacility | MODA | CONNEXUS-SYNERGY-OHSU PPO | $1.90 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| GOOD SAMARITAN REGIONAL MEDICAL CENTER BothFacility | CIGNA | ALL PRODUCTS | $1.90 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL BothFacility | AETNA | ALL PRODUCTS | $1.90 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| GOOD SAMARITAN REGIONAL MEDICAL CENTER BothFacility | AETNA | ALL PRODUCTS | $1.90 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | CIGNA | ALL PRODUCTS | $1.94 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | PROVIDENCE | INDIVIDUAL-STANDARD | $1.94 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | HEALTHNET | ALL PRODUCTS | $1.94 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN ALBANY GENERAL HOSPITAL OutpatientFacility | PROVIDENCE | EPO - NON PEBB/OEBB | $1.94 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL OutpatientFacility | PROVIDENCE | INDIVIDUAL-STANDARD | $1.94 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL BothFacility | HEALTHNET | ALL PRODUCTS | $1.94 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL OutpatientFacility | PROVIDENCE | EPO - NON PEBB/OEBB | $1.94 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL OutpatientFacility | PROVIDENCE | EPO - PEBB/OEBB | $1.94 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL BothFacility | HEALTHNET | ALL PRODUCTS | $1.94 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | HEALTHNET | ALL PRODUCTS | $1.94 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL BothFacility | CIGNA | ALL PRODUCTS | $1.94 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | CIGNA | ALL PRODUCTS | $1.94 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | PROVIDENCE | EPO - PEBB/OEBB | $1.94 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | PROVIDENCE | EPO - NON PEBB/OEBB | $1.94 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN ALBANY GENERAL HOSPITAL BothFacility | HEALTHNET | ALL PRODUCTS | $1.94 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| GOOD SAMARITAN REGIONAL MEDICAL CENTER BothFacility | HEALTHNET | ALL PRODUCTS | $1.94 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL OutpatientFacility | PROVIDENCE | EPO - PEBB/OEBB | $1.94 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL OutpatientFacility | PROVIDENCE | EPO - NON PEBB/OEBB | $1.94 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | PROVIDENCE | EPO - PEBB/OEBB | $1.94 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL OutpatientFacility | PROVIDENCE | INDIVIDUAL-STANDARD | $1.94 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL BothFacility | CIGNA | ALL PRODUCTS | $1.94 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | PROVIDENCE | INDIVIDUAL-STANDARD | $1.94 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | PROVIDENCE | EPO - NON PEBB/OEBB | $1.94 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| GOOD SAMARITAN REGIONAL MEDICAL CENTER OutpatientFacility | PROVIDENCE | EPO - NON PEBB/OEBB | $1.94 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | HUMANA | ALL PRODUCTS | $1.95 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL BothFacility | HUMANA | ALL PRODUCTS | $1.95 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | Carelon | MAP_Medicare Advantage | $1.95 | $3.00 | — | 2026-09-05 | MRF ↗ |
| GOOD SAMARITAN REGIONAL MEDICAL CENTER BothFacility | HUMANA | ALL PRODUCTS | $1.95 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | HUMANA | ALL PRODUCTS | $1.95 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SAMARITAN ALBANY GENERAL HOSPITAL BothFacility | HUMANA | ALL PRODUCTS | $1.95 | $2.00 | $1.60 | 2026-01-31 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | Carelon | GHI BMP | $1.95 | $3.00 | — | 2026-09-05 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | Elderplan | MAP_Medicare Advantage_MLTC | $1.95 | $3.00 | — | 2026-09-05 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | Carelon | Commercial_Essential Plans | $1.95 | $3.00 | — | 2026-09-05 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | Carelon | Managed Medicaid_HARP_CHP | $1.95 | $3.00 | — | 2026-09-05 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | EMBLEM | Essential Plan 1-2 | $2.10 | $3.00 | — | 2026-09-05 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | Aetna | ALL PRODUCTS | $2.10 | $3.00 | — | 2026-09-05 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | EMBLEM | MEDICARE ADVANTAGE | $2.10 | $3.00 | — | 2026-09-05 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | Emblem | Essential Plan 200-250 | $2.10 | $3.00 | — | 2026-09-05 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | HAP | Self Insured | $2.10 | $9,401.30 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | HAP | Self Insured | $2.10 | $9,401.30 | — | 2025-06-28 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | HAP | Self Insured | $2.10 | $9,401.30 | — | 2025-06-28 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | MAGNACARE | PPO Non-FPP | $2.25 | $3.00 | — | 2026-09-05 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | MAGNACARE | Direct Plus Non-FPP | $2.25 | $3.00 | — | 2026-09-05 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | MAGNACARE | Direct Plus FPP | $2.25 | $3.00 | — | 2026-09-05 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | CIGNA | ALL PRODUCTS | $2.25 | $3.00 | — | 2026-09-05 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | MAGNACARE | PPO FPP | $2.25 | $3.00 | — | 2026-09-05 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | UNITED | ALL PRODUCTS | $2.40 | $3.00 | — | 2026-09-05 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | UNITED | EXCHANGE | $2.40 | $3.00 | — | 2026-09-05 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | ANTHEM | Blue Access Large Group | $2.40 | $3.00 | — | 2026-09-05 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | EMBLEM | PPO_Commercial | $2.40 | $3.00 | — | 2026-09-05 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | ANTHEM | INDEMNITY | $2.40 | $3.00 | — | 2026-09-05 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | EMBLEM | HIP_GHI_CHP | $2.40 | $3.00 | — | 2026-09-05 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | MULTIPLAN | ALL PRODUCTS | $2.40 | $3.00 | — | 2026-09-05 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | Carelon (Amida Care) | Managed Medicaid | $2.40 | $3.00 | — | 2026-09-05 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | ANTHEM | Blue Access Small Group | $2.40 | $3.00 | — | 2026-09-05 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | ANTHEM | Small Group EPO_PPO | $2.40 | $3.00 | — | 2026-09-05 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | ANTHEM | HMO | $2.40 | $3.00 | — | 2026-09-05 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | ANTHEM | EPO | $2.40 | $3.00 | — | 2026-09-05 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | ANTHEM | PPO | $2.40 | $3.00 | — | 2026-09-05 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | VNSNY | Medicare SNP | $2.55 | $3.00 | — | 2026-09-05 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | VNSNY | Medicaid SNP | $2.55 | $3.00 | — | 2026-09-05 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | Amidacare | Managed Medicaid | $2.55 | $3.00 | — | 2026-09-05 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | VillageCare Max | MEDICARE ADVANTAGE | $2.55 | $3.00 | — | 2026-09-05 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | VillageCare Max | MAP | $2.55 | $3.00 | — | 2026-09-05 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | VNSNY | Medicare Advantage | $2.55 | $3.00 | — | 2026-09-05 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | Local 1199 | ALL PRODUCTS | $2.55 | $3.00 | — | 2026-09-05 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | VNSNY | MAP | $2.55 | $3.00 | — | 2026-09-05 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | BCBS | Medicare Advantage-PPO | $2.94 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | BCBS | Medicare Advantage-PPO | $2.94 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| FLAGLER HOSPITAL OutpatientFacility | Aetna | Medicare Advantage | $3.42 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | BCBS | Medicare Advantage-HMO | $3.42 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | BCBS | Medicare Advantage-HMO | $3.42 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| UF HEALTH SHANDS HOSPITAL OutpatientFacility | BCBS | Medicare Advantage-PPO | $3.89 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| UF HEALTH SHANDS HOSPITAL OutpatientFacility | BCBS | Medicare Advantage-HMO | $3.89 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| FLAGLER HOSPITAL OutpatientFacility | Aetna | All Products | $4.10 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | Aetna Health | Medicare Advantage | $4.56 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | Aetna Health | Medicare Advantage | $4.56 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | BCBS | Gatorcare | $5.60 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | BCBS | Gatorcare | $5.60 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE BothFacility | WellCare of Florida | Medicare Advantage/HMO/POS/SNP | $5.69 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE BothFacility | WellCare of Florida | Medicare Advantage/HMO/POS/SNP | $5.69 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | BCBS | Blue Select PPO | $5.82 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | BCBS | Blue Select PPO | $5.82 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | BCBS | SimplyBlue Commercial | $6.01 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | BCBS | MyBlue HMO | $6.01 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | BCBS | SimplyBlue Commercial | $6.01 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | BCBS | MyBlue HMO | $6.01 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| FLAGLER HOSPITAL OutpatientFacility | BCBS | My Blue | $6.89 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | Florida Health Care Plan | MEDICARE HMO | $7.21 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | Florida Health Care Plan | MEDICARE HMO | $7.21 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| UF HEALTH SHANDS HOSPITAL BothFacility | UAA | Student Athletes | $7.23 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | BCBS | Commercial-HMO | $7.25 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | BCBS | Commercial-HMO | $7.25 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE BothFacility | BCBS | NWB | $7.46 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE BothFacility | BCBS | JUF | $7.46 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE BothFacility | BCBS | PPO | $7.46 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE BothFacility | BCBS | NWB | $7.46 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE BothFacility | BCBS | CUF | $7.46 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE BothFacility | BCBS | JUF | $7.46 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE BothFacility | BCBS | PPO | $7.46 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE BothFacility | BCBS | CUF | $7.46 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| FLAGLER HOSPITAL OutpatientFacility | BCBS | PHS | $7.52 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| FLAGLER HOSPITAL OutpatientFacility | BCBS | Simply Blue | $7.52 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| FLAGLER HOSPITAL OutpatientFacility | BCBS | PPO | $7.52 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| FLAGLER HOSPITAL OutpatientFacility | BCBS | Network Blue | $7.52 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| UF HEALTH SHANDS HOSPITAL OutpatientFacility | Molina | Medicaid HMO | $7.59 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| UF HEALTH SHANDS HOSPITAL OutpatientFacility | Aetna Better Health | Medicaid HMO | $7.59 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| UF HEALTH SHANDS HOSPITAL OutpatientFacility | Devoted Health Plan | Medicare HMO | $7.59 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | MOLINA | MEDICAID HMO | $7.59 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | Devoted Health Plan | MEDICARE HMO | $7.59 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | Devoted Health Plan | Medicare PPO | $7.59 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | Aetna Better Health | MEDICAID HMO | $7.59 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | Aetna Better Health | Healthy Kids | $7.59 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | AMBETTER | ALL PRODUCTS | $7.59 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| UF HEALTH SHANDS HOSPITAL OutpatientFacility | Aetna Better Health | Healthy Kids | $7.59 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| UF HEALTH SHANDS HOSPITAL OutpatientFacility | Devoted Health Plan | Medicare PPO | $7.59 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE BothFacility | Simply Healthcare | Fl Healthy Kids | $7.59 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| UF HEALTH SHANDS HOSPITAL BothFacility | Simply Healthcare | MCD HMO | $7.59 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| UF HEALTH SHANDS HOSPITAL OutpatientFacility | Sunshine State Health Plan | Medicaid HMO | $7.59 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| FLAGLER HOSPITAL OutpatientFacility | Aetna | Managed Medicaid | $7.59 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE BothFacility | Simply Healthcare | MCD HMO | $7.59 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | AMBETTER | ALL PRODUCTS | $7.59 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | Aetna Better Health | MEDICAID HMO | $7.59 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | Devoted Health Plan | MEDICARE HMO | $7.59 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | Aetna Better Health | Healthy Kids | $7.59 | $18.98 | $10.44 | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | Devoted Health Plan | Medicare PPO | $7.59 | $18.98 | $10.44 | 2026-03-31 | 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.