69413033030 — Pyrimethamine 25 Mg Tablet
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). pyrimethamine 25 mg Tablet (NDC 69413033030) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/69413033030?code_type=NDC
MLA (9th ed.)
“pyrimethamine 25 mg Tablet (NDC 69413033030) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/69413033030?code_type=NDC. Accessed .
Chicago (notes-bibliography)
“pyrimethamine 25 mg Tablet (NDC 69413033030) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/69413033030?code_type=NDC.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $691–$4,434 (25th–75th percentile) across 10 hospitals · 76 payers.
“Negotiated” is the hospital’s negotiated facility rate for this NDC 69413033030 — 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 |
|---|---|---|---|---|---|---|---|
| KAHUKU MEDICAL CENTER Both | AlohaCare | Mcd HMO | $1.05 | $3.00 | $1.95 | 2024-06-28 | MRF ↗ |
| KAHUKU MEDICAL CENTER Both | Kaiser | Mcd HMO | $1.17 | $3.00 | $1.95 | 2024-06-28 | MRF ↗ |
| KAHUKU MEDICAL CENTER Both | Ohana | Mcd HMO | $1.20 | $3.00 | $1.95 | 2024-06-28 | MRF ↗ |
| KAHUKU MEDICAL CENTER Both | UHC | McrAdv | $1.47 | $3.00 | $1.95 | 2024-06-28 | MRF ↗ |
| KAHUKU MEDICAL CENTER Both | Ohana | McrAdv | $1.47 | $3.00 | $1.95 | 2024-06-28 | MRF ↗ |
| KAHUKU MEDICAL CENTER Both | HMSA | McrAdv | $1.47 | $3.00 | $1.95 | 2024-06-28 | MRF ↗ |
| KAHUKU MEDICAL CENTER Both | AlohaCare | McrAdv | $1.47 | $3.00 | $1.95 | 2024-06-28 | MRF ↗ |
| KAHUKU MEDICAL CENTER Both | Kaiser | McrAdv | $1.47 | $3.00 | $1.95 | 2024-06-28 | MRF ↗ |
| KAHUKU MEDICAL CENTER Both | Humana | McrAdv | $1.47 | $3.00 | $1.95 | 2024-06-28 | MRF ↗ |
| KAHUKU MEDICAL CENTER Both | UHA | PPO | $2.27 | $3.00 | $1.95 | 2024-06-28 | MRF ↗ |
| KAHUKU MEDICAL CENTER Both | DMBA | PPO | $2.40 | $3.00 | $1.95 | 2024-06-28 | MRF ↗ |
| KAHUKU MEDICAL CENTER Both | HMA | PPO | $2.40 | $3.00 | $1.95 | 2024-06-28 | MRF ↗ |
| KAHUKU MEDICAL CENTER Both | Kaiser | PPO | $2.70 | $3.00 | $1.95 | 2024-06-28 | MRF ↗ |
| KAHUKU MEDICAL CENTER Both | HMAA | PPO | $2.79 | $3.00 | $1.95 | 2024-06-28 | MRF ↗ |
| KAHUKU MEDICAL CENTER Both | MDX | PPO | $2.91 | $3.00 | $1.95 | 2024-06-28 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Inpatient | Aetna | Hmo | $253.70 | $3,637.50 | $3,637.50 | 2026-07-15 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | AETNA | MEDICARE | $406.80 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | AETNA | MEDICARE | $406.80 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Aetna Health | Managed Choice Pos And Elect Choice | — | $3,150.00 | $315.00 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER OutpatientFacility | — | — | — | $3,150.00 | $315.00 | 2025-10-23 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | United Healthcare | All Payer Appendix | — | $3,150.00 | $315.00 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | United Healthcare | Medicare Advantage | — | $3,150.00 | $315.00 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Humana | Commercial Ppo | — | $3,150.00 | $315.00 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Humana | Medicare Advantage | — | $3,150.00 | $315.00 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Humana | Healthy Horizons Medicaid Transplant Agre | — | $3,150.00 | $315.00 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Humana | Healthy Horizons Medicaid | — | $3,150.00 | $315.00 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Wellpath | Governmental | — | $3,150.00 | $315.00 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Aetna Health | National Advantage Program | — | $3,150.00 | $315.00 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Aetna Health | Hmo | — | $3,150.00 | $315.00 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Aetna Better Health | Managed Medicaid | — | $3,150.00 | $315.00 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Aetna Health | Open Choice Ppo | $448.00 | $3,150.00 | $315.00 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Ameri-Plus Preferred Care Inc | Medicare Advantage | — | $3,150.00 | $315.00 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Blue Cross Blue Shield Of Ok | Blue Plan65 Select | — | $3,150.00 | $315.00 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Blue Cross Blue Shield Of Ok | Nativeblue | — | $3,150.00 | $315.00 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Cigna Health | All Other Ppo | — | $3,150.00 | $315.00 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Cigna Health | Ppo Payor Solutions/Strategic Allia | — | $3,150.00 | $315.00 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Cigna Health | All Products Except Ppo | — | $3,150.00 | $315.00 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Cigna Health - C | 20 New Business Network | — | $3,150.00 | $315.00 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Communitycare | Communitycare Plus | — | $3,150.00 | $315.00 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Communitycare | Hmo Commercial | — | $3,150.00 | $315.00 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Healthcare Highways - Commercial - D | 3.1 | — | $3,150.00 | $315.00 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Healthcare Highways - Commercial - D | 5 | — | $3,150.00 | $315.00 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Healthcare Highways - Commercial - D | 2 | — | $3,150.00 | $315.00 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Healthcare Highways - Commercial - D | 6 | — | $3,150.00 | $315.00 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Healthcare Highways - Commercial -D | 4 | — | $3,150.00 | $315.00 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Healthcare Highways - Commercial -D | 1 | — | $3,150.00 | $315.00 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Healthsmart Preferred Care | Ppo | — | $3,150.00 | $315.00 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Healthsmart Preferred Care | Accel | — | $3,150.00 | $315.00 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Oklahoma Complete Care | Medicare Advantage | — | $3,150.00 | $315.00 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Oklahoma Complete Care | Managed Medicaid | — | $3,150.00 | $315.00 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Quiktrip | Commercial | — | $3,150.00 | $315.00 | 2026-07-18 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Preferred Communitychoice | Ppo | — | $3,150.00 | $315.00 | 2026-07-18 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | PENSACOLA | CHRISTIAN COLL | $540.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | FL BLUE | MY BLUE NETWORK | $540.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | PENSACOLA | CHRISTIAN COLL | $540.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | FL BLUE | HEALTH OPTIONS HMO | $684.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | FL BLUE | BLUE SELECT | $684.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | FL BLUE | SIMPLY BLUE NETWORK | $684.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Inpatient | United Healthcare | Medicaid | $690.54 | $3,637.50 | $3,637.50 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Inpatient | Aetna | Better Health Medicaid | $690.54 | $3,637.50 | $3,637.50 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Inpatient | Fidelis Wellcare | Medicaid | $690.54 | $3,637.50 | $3,637.50 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Inpatient | Healthnet Federal | Ppo Pc3 | $712.50 | $3,637.50 | $3,637.50 | 2026-07-15 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | FL BLUE | MY BLUE NETWORK | $756.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Inpatient | Aetna | Pos, Epo, Ppo | $785.70 | $3,637.50 | $3,637.50 | 2026-07-15 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | WELLCARE | MCARE HMO | $792.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | WELLCARE | MCARE HMO DUAL PLAN | $792.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | UHC | MCARE ADV PLN | $792.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | UHC | MCARE ADV DUAL PLAN | $792.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | BC FL | MEDICARE HMO | $792.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | HUMANA | MCARE CHOICE PPO | $792.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | AETNA | MEDICARE | $792.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | FL BLUE | NWB - BLUE OPTIONS | $828.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | UHC OF FL | NEIGHBORHOOD PLAN | $853.20 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | FL BLUE | SIMPLY BLUE NETWORK | $864.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | FL BLUE | MY BLUE NETWORK | $864.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | FL BLUE | BLUE SELECT | $864.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | UHC OF FL | POS/HMO | $892.80 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | UHC COMMUNITY | MCAID HMO | $900.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | UHC COMMUNITY | MCAID HMO | $900.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | UHC COMMUNITY | MCAID HMO | $900.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Inpatient | Amerigroup | Wellcare Medicaid | $909.38 | $3,637.50 | $3,637.50 | 2026-07-15 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | BC FL | MEDICARE HMO | $936.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Inpatient | Cigna | Commercial | $953.33 | $3,637.50 | $3,637.50 | 2026-07-15 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | UHC OF FL | POS/HMO | $954.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | UHC OF FL | POS/HMO | $954.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | FL BLUE | PPC-BLUE CHOICE | $972.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | FL BLUE | HEALTH OPTIONS HMO | $1,008.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | FL BLUE | BLUE SELECT | $1,008.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | FL BLUE | SIMPLY BLUE NETWORK | $1,008.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | FL BLUE | INDEMNITY | $1,044.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | HOSPICE REGENCY | ALL PRODUCTS | $1,080.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | HOSPICE REGENCY | ALL PRODUCTS | $1,080.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | BC FL | MEDICARE HMO | $1,116.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | FL BLUE | HEALTH OPTIONS HMO | $1,152.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | FL BLUE | NWB - BLUE OPTIONS | $1,260.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | FL BLUE | NWB - BLUE OPTIONS | $1,296.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | FL BLUE | INDEMNITY | $1,332.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | FL BLUE | PPC-BLUE CHOICE | $1,440.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | FL BLUE | PPC-BLUE CHOICE | $1,692.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| GULF BREEZE HOSPITAL BothFacility | CIGNA/GREAT WEST | PPO | $1,710.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| BAPTIST HOSPITAL BothFacility | CIGNA/GREAT WEST | PPO | $1,710.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | HOSPICE EMERALD COAST | ALL PRODUCTS | $1,800.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | HOSPICE EMERALD COAST | ALL PRODUCTS | $1,800.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| GULF BREEZE HOSPITAL BothFacility | AETNA | PPO | $1,800.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| BAPTIST HOSPITAL BothFacility | AETNA | PPO | $1,800.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | HOSPICE EMERALD COAST | ALL PRODUCTS | $1,800.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | HOSPICE VITAS | ALL PRODUCTS | $1,800.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | HOSPICE REGENCY | ALL PRODUCTS | $1,800.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL BothFacility | CIGNA/GREAT WEST | PPO | $1,998.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Inpatient | Brighton | Commercial | $2,000.63 | $3,637.50 | $3,637.50 | 2026-07-15 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | AETNA | AETNA | $2,028.24 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | CIGNA/GREAT WEST | OPEN ACCESS | $2,037.60 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | CIGNA/GREAT WEST | OPEN ACCESS | $2,152.80 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | CIGNA/GREAT WEST | OPEN ACCESS | $2,156.40 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| BAPTIST HOSPITAL BothFacility | ESCAMBIA | BOY BASE | $2,160.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL BothFacility | CIGNA | INDEMNITY | $2,167.20 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Inpatient | Amerihealth | Lvn | $2,182.50 | $3,637.50 | $3,637.50 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Inpatient | Horizon | Omnia | $2,219.97 | $3,637.50 | $3,637.50 | 2026-07-15 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | INTEL | ALL PRODUCTS | $2,264.40 | $5,661.00 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | HEALTHCOMP | ALL PRODUCTS | $2,264.40 | $5,661.00 | — | 2026-01-01 | MRF ↗ |
| BAPTIST HOSPITAL BothFacility | UWF ATHLETES | ALL PRODUCTS | $2,340.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| BAPTIST HOSPITAL BothFacility | PRIVATE HEALTHCARE | PPO | $2,340.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| GULF BREEZE HOSPITAL BothFacility | UWF ATHLETES | ALL PRODUCTS | $2,340.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| GULF BREEZE HOSPITAL BothFacility | PRIVATE HEALTHCARE | PPO | $2,340.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL BothFacility | PRIVATE HEALTHCARE | PPO | $2,340.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | CIGNA SELECT | ALL PRODUCTS | $2,360.64 | $5,661.00 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | CIGNA | SUREFIT | $2,377.62 | $5,661.00 | — | 2026-01-01 | MRF ↗ |
| BAPTIST HOSPITAL BothFacility | AETNA | INDEMNITY | $2,419.20 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| GULF BREEZE HOSPITAL BothFacility | AETNA | INDEMNITY | $2,419.20 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Inpatient | United Healthcare | Oxford | $2,425.12 | $3,637.50 | $3,637.50 | 2026-07-15 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | UHC | NAVIGATE | $2,462.54 | $5,661.00 | — | 2026-01-01 | MRF ↗ |
| GULF BREEZE HOSPITAL BothFacility | FIRST HEALTH | PPO | $2,502.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| BAPTIST HOSPITAL BothFacility | FIRST HEALTH | PPO | $2,502.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL BothFacility | FIRST HEALTH | PPO | $2,552.40 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| BAPTIST HOSPITAL BothFacility | WC CORVEL | PPO | $2,565.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| GULF BREEZE HOSPITAL BothFacility | WC CORVEL | PPO | $2,565.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL BothFacility | WC CORVEL | PPO | $2,565.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Inpatient | Liberty Mutual | Commercial | $2,571.71 | $3,637.50 | $3,637.50 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Inpatient | Horizon | Ppo Hmo | $2,572.08 | $3,637.50 | $3,637.50 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Inpatient | Horizon | Indemnity | $2,572.08 | $3,637.50 | $3,637.50 | 2026-07-15 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AETNA | ALL PRODUCTS | $2,592.74 | $5,661.00 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | CIGNA | ALL PRODUCTS | $2,671.99 | $5,661.00 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | UHC | NON OPTIONS | $2,677.65 | $5,661.00 | — | 2026-01-01 | MRF ↗ |
| BAPTIST HOSPITAL BothFacility | CHOICECARE | PPO | $2,700.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| BAPTIST HOSPITAL BothFacility | MH CHOICECARE | PPO | $2,700.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| GULF BREEZE HOSPITAL BothFacility | CHOICECARE | PPO | $2,700.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Inpatient | First Mco | Workers Comp | $2,728.13 | $3,637.50 | $3,637.50 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Inpatient | Healthnet | Tricare | $2,728.13 | $3,637.50 | $3,637.50 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Inpatient | Amerihealth | Rp | $2,728.13 | $3,637.50 | $3,637.50 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Inpatient | Qualcare Health Republic Of Nj Humana | Workers' Comp | $2,728.13 | $3,637.50 | $3,637.50 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Inpatient | Chn | Municiple Joint Insurance Fund | $2,728.13 | $3,637.50 | $3,637.50 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Inpatient | Chn | Commercial | $3,091.88 | $3,637.50 | $3,637.50 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Inpatient | First Mco | Group Health | $3,091.88 | $3,637.50 | $3,637.50 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Inpatient | Magnacare | Commercial | $3,091.88 | $3,637.50 | $3,637.50 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Inpatient | Magnacare | Workers' Compensation | $3,091.88 | $3,637.50 | $3,637.50 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Inpatient | Mulitplan | Commercial | $3,091.88 | $3,637.50 | $3,637.50 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Inpatient | Chn | Workers Compensation | $3,091.88 | $3,637.50 | $3,637.50 | 2026-07-15 | MRF ↗ |
| JAY HOSPITAL BothFacility | MULTIPLAN | PPO | $3,204.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| BAPTIST HOSPITAL BothFacility | MULTIPLAN | PPO | $3,204.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| GULF BREEZE HOSPITAL BothFacility | MULTIPLAN | PPO | $3,204.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Inpatient | Galaxy | Commercial | $3,273.75 | $3,637.50 | $3,637.50 | 2026-07-15 | MRF ↗ |
| JAY HOSPITAL InpatientFacility | WC CORVEL | PPO | $3,420.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| BAPTIST HOSPITAL InpatientFacility | WC CORVEL | PPO | $3,420.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| GULF BREEZE HOSPITAL InpatientFacility | WC CORVEL | PPO | $3,420.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Inpatient | Chn | Automobile/Pip | $3,455.63 | $3,637.50 | $3,637.50 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Inpatient | Magnacare | Auto Personal Injury Protection No Fault | $3,455.63 | $3,637.50 | $3,637.50 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Inpatient | Galaxy | Workers Comp | $3,455.63 | $3,637.50 | $3,637.50 | 2026-07-15 | MRF ↗ |
| JAY HOSPITAL InpatientFacility | CIGNA | INDEMNITY | $3,600.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| GULF BREEZE HOSPITAL BothFacility | CIGNA | INDEMNITY | $3,600.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| BAPTIST HOSPITAL BothFacility | CIGNA | INDEMNITY | $3,600.00 | $3,600.00 | $540.00 | 2025-12-23 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Inpatient | Multiplan | Auto Workers' Compensation | $3,637.50 | $3,637.50 | $3,637.50 | 2026-07-15 | MRF ↗ |
| Arkansas Children's Hospital Inpatient | Municipal Health Benefit Fund | All Plans | — | $59,131.60 | $53,218.44 | 2026-07-15 | MRF ↗ |
| Arkansas Children's Hospital Inpatient | Vantage Health | All Plans | — | $59,131.60 | $53,218.44 | 2026-07-15 | MRF ↗ |
| Arkansas Children's Hospital Inpatient | Sharp | All Plans | — | $59,131.60 | $53,218.44 | 2026-07-15 | MRF ↗ |
| Arkansas Children's Hospital Inpatient | Ambetter, Qualchoice Novasys | All Plans | — | $59,131.60 | $53,218.44 | 2026-07-15 | MRF ↗ |
| Arkansas Children's Hospital Inpatient | American Lifecare | All Plans | — | $59,131.60 | $53,218.44 | 2026-07-15 | MRF ↗ |
| Arkansas Children's Hospital Inpatient | American Ppo Inc. | All Plans | — | $59,131.60 | $53,218.44 | 2026-07-15 | MRF ↗ |
| Arkansas Children's Hospital Inpatient | Cigna | All Plans | — | $59,131.60 | $53,218.44 | 2026-07-15 | MRF ↗ |
| Arkansas Children's Hospital Inpatient | Cigna Accn Network | All Plans | — | $59,131.60 | $53,218.44 | 2026-07-15 | MRF ↗ |
| Arkansas Children's Hospital Inpatient | First Community Bank Corp Benefit | All Plans | — | $59,131.60 | $53,218.44 | 2026-07-15 | MRF ↗ |
| Arkansas Children's Hospital Inpatient | Health Partners Pho | All Plans | — | $59,131.60 | $53,218.44 | 2026-07-15 | MRF ↗ |
| Arkansas Children's Hospital Inpatient | First Health | All Plans | — | $59,131.60 | $53,218.44 | 2026-07-15 | MRF ↗ |
| Arkansas Children's Hospital Inpatient | Mercy Managed Care | All Plans | — | $59,131.60 | $53,218.44 | 2026-07-15 | MRF ↗ |
| Arkansas Children's Hospital Inpatient | Ppo Plus (Stratose) | All Plans | — | $59,131.60 | $53,218.44 | 2026-07-15 | MRF ↗ |
| Arkansas Children's Hospital Inpatient | Vantos Health System | All Plans | — | $59,131.60 | $53,218.44 | 2026-07-15 | MRF ↗ |
| Arkansas Children's Hospital Inpatient | White River Health System | All Plans | — | $59,131.60 | $53,218.44 | 2026-07-15 | MRF ↗ |
| Arkansas Children's Hospital Inpatient | Multiplan | All Plans | — | $59,131.60 | $53,218.44 | 2026-07-15 | MRF ↗ |
| Arkansas Children's Hospital Inpatient | Phcs | All Plans | — | $59,131.60 | $53,218.44 | 2026-07-15 | MRF ↗ |
| Arkansas Children's Hospital Inpatient | Three Rivers Provider Network | All Plans | — | $59,131.60 | $53,218.44 | 2026-07-15 | MRF ↗ |
| Arkansas Children's Hospital Inpatient | United Healthcare | All Plans | — | $59,131.60 | $53,218.44 | 2026-07-15 | MRF ↗ |
| Arkansas Children's Hospital Inpatient | Aetna | All Plans | — | $59,131.60 | $53,218.44 | 2026-07-15 | MRF ↗ |
| Arkansas Children's Hospital Inpatient | Zelis | All Plans | — | $59,131.60 | $53,218.44 | 2026-07-15 | MRF ↗ |
| Arkansas Children's Hospital Inpatient | Healthscope Benefits | All Plans | — | $59,131.60 | $53,218.44 | 2026-07-15 | MRF ↗ |
| Arkansas Children's Hospital Inpatient | Usa Managed Care | All Plans | — | $59,131.60 | $53,218.44 | 2026-07-15 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL BothFacility | ANTIDOTE | ALL PRODUCTS | $3,679.65 | $5,661.00 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL BothFacility | CIGNA | TXP LIFESOURCE TRANSPLANT | $3,940.06 | $5,661.00 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL BothFacility | AETNA | HEALTHEZ | $4,149.51 | $5,661.00 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL InpatientFacility | CIGNA | TXP LIFESOURCE TRANSPLANT | $4,296.70 | $5,661.00 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL BothFacility | MULTIPLAN | ALL PRODUCTS | $4,528.80 | $5,661.00 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL BothFacility | CIGNA | BEHAVIORAL HEALTH | $4,528.80 | $5,661.00 | — | 2026-01-01 | 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.