75987008010 — Pegloticase 8 Mg/ml IV Soln
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). PEGLOTICASE 8 MG/ML IV SOLN (NDC 75987008010) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/75987008010?code_type=NDC
MLA (9th ed.)
“PEGLOTICASE 8 MG/ML IV SOLN (NDC 75987008010) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/75987008010?code_type=NDC. Accessed .
Chicago (notes-bibliography)
“PEGLOTICASE 8 MG/ML IV SOLN (NDC 75987008010) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/75987008010?code_type=NDC.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $3,828–$49,173 (25th–75th percentile) across 14 hospitals · 159 payers.
“Negotiated” is the hospital’s negotiated facility rate for this NDC 75987008010 — 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 |
|---|---|---|---|---|---|---|---|
| SAMARITAN LEBANON COMMUNITY HOSPITAL BothFacility | PROVIDENCE | MA-BEHAVIORAL HEALTH | $31.90 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL BothFacility | PROVIDENCE | MEDICARE ADV. | $31.90 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL OutpatientFacility | SAMARITAN | MEDICARE ADV. | $32.22 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL OutpatientFacility | HEALTHNET | MEDICARE ADV. | $35.09 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL OutpatientFacility | REGENCE | MEDICARE ADV. | $35.09 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL OutpatientFacility | PACIFICSOURCE | MEDICARE ADV. | $35.73 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | PROVIDENCE | MEDICARE ADV. | $36.30 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | PROVIDENCE | MEDICARE ADV. | $36.30 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | SAMARITAN | MEDICARE ADV. | $36.66 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | SAMARITAN | MEDICARE ADV. | $36.66 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | HUMANA | MEDICARE ADV. | $36.66 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | HUMANA | MEDICARE ADV. | $36.66 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL OutpatientFacility | DEVOTED HEALTH | DEVOTED HEALTH MCR ADVANTAGE | $36.69 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL OutpatientFacility | PROVIDENCE | MEDICARE ADV. | $39.60 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | REGENCE | MEDICARE ADV. | $39.93 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | REGENCE | MEDICARE ADV. | $39.93 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL OutpatientFacility | SAMARITAN | MEDICARE ADV. | $40.00 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | PACIFICSOURCE | MEDICARE ADV. | $40.66 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | PACIFICSOURCE | MEDICARE ADV. | $40.66 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | DEVOTED HEALTH | DEVOTED HEALTH MCR ADVANTAGE | $41.75 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | DEVOTED HEALTH | DEVOTED HEALTH MCR ADVANTAGE | $41.75 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL OutpatientFacility | REGENCE | MEDICARE ADV. | $43.56 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL OutpatientFacility | PACIFICSOURCE | MEDICARE ADV. | $44.35 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL OutpatientFacility | DEVOTED HEALTH | DEVOTED HEALTH MCR ADVANTAGE | $45.54 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| GOOD SAMARITAN REGIONAL MEDICAL CENTER OutpatientFacility | SAMARITAN | MEDICARE ADV. | $55.00 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN ALBANY GENERAL HOSPITAL OutpatientFacility | SAMARITAN | MEDICARE ADV. | $55.00 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| GOOD SAMARITAN REGIONAL MEDICAL CENTER OutpatientFacility | PROVIDENCE | MEDICARE ADV. | $73.70 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN ALBANY GENERAL HOSPITAL OutpatientFacility | PROVIDENCE | MEDICARE ADV. | $73.70 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL BothFacility | SAMARITAN | EPO | $77.00 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL BothFacility | SAMARITAN | EPO | $77.00 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | SAMARITAN | EPO | $77.00 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | SAMARITAN | EPO | $77.00 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| GOOD SAMARITAN REGIONAL MEDICAL CENTER OutpatientFacility | PACIFICSOURCE | MEDICARE ADV. | $77.00 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL BothFacility | SAMARITAN | SAMARITAN CHOICE | $88.00 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | SAMARITAN | SAMARITAN CHOICE | $88.00 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN ALBANY GENERAL HOSPITAL BothFacility | SAMARITAN | SAMARITAN CHOICE | $88.00 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| GOOD SAMARITAN REGIONAL MEDICAL CENTER BothFacility | SAMARITAN | SAMARITAN CHOICE | $88.00 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL BothFacility | SAMARITAN | SAMARITAN CHOICE | $88.00 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | SAMARITAN | SAMARITAN CHOICE | $88.00 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| GOOD SAMARITAN REGIONAL MEDICAL CENTER BothFacility | REGENCE | ALL PRODUCTS | $92.62 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN ALBANY GENERAL HOSPITAL BothFacility | REGENCE | ALL PRODUCTS | $92.62 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | SAMARITAN | SAMARITAN GROUP | $93.50 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL BothFacility | SAMARITAN | SAMARITAN GROUP | $93.50 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | SAMARITAN | SAMARITAN GROUP | $93.50 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL BothFacility | SAMARITAN | SAMARITAN GROUP | $93.50 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | REGENCE | ALL PRODUCTS | $98.88 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL BothFacility | REGENCE | ALL PRODUCTS | $98.88 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL BothFacility | REGENCE | ALL PRODUCTS | $98.88 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | REGENCE | ALL PRODUCTS | $98.88 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| GOOD SAMARITAN REGIONAL MEDICAL CENTER OutpatientFacility | PROVIDENCE | INDIVIDUAL-STANDARD | $103.40 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL BothFacility | AETNA | ALL PRODUCTS | $104.50 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN ALBANY GENERAL HOSPITAL BothFacility | CIGNA | ALL PRODUCTS | $104.50 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN ALBANY GENERAL HOSPITAL BothFacility | AETNA | ALL PRODUCTS | $104.50 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | MODA | CONNEXUS-SYNERGY-OHSU PPO | $104.50 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL BothFacility | MODA | CONNEXUS-SYNERGY-OHSU PPO | $104.50 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| GOOD SAMARITAN REGIONAL MEDICAL CENTER BothFacility | AETNA | ALL PRODUCTS | $104.50 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL BothFacility | AETNA | ALL PRODUCTS | $104.50 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | AETNA | ALL PRODUCTS | $104.50 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | MODA | CONNEXUS-SYNERGY-OHSU PPO | $104.50 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| GOOD SAMARITAN REGIONAL MEDICAL CENTER BothFacility | CIGNA | ALL PRODUCTS | $104.50 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | AETNA | ALL PRODUCTS | $104.50 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL OutpatientFacility | PROVIDENCE | EPO - NON PEBB/OEBB | $106.70 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | PROVIDENCE | EPO - PEBB/OEBB | $106.70 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL OutpatientFacility | PROVIDENCE | EPO - PEBB/OEBB | $106.70 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | PROVIDENCE | EPO - NON PEBB/OEBB | $106.70 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | HEALTHNET | ALL PRODUCTS | $106.70 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | PROVIDENCE | EPO - PEBB/OEBB | $106.70 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | CIGNA | ALL PRODUCTS | $106.70 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL OutpatientFacility | PROVIDENCE | INDIVIDUAL-STANDARD | $106.70 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL BothFacility | CIGNA | ALL PRODUCTS | $106.70 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL BothFacility | HEALTHNET | ALL PRODUCTS | $106.70 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| GOOD SAMARITAN REGIONAL MEDICAL CENTER BothFacility | HEALTHNET | ALL PRODUCTS | $106.70 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| GOOD SAMARITAN REGIONAL MEDICAL CENTER OutpatientFacility | PROVIDENCE | EPO - NON PEBB/OEBB | $106.70 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | PROVIDENCE | INDIVIDUAL-STANDARD | $106.70 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN ALBANY GENERAL HOSPITAL BothFacility | HEALTHNET | ALL PRODUCTS | $106.70 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN ALBANY GENERAL HOSPITAL OutpatientFacility | PROVIDENCE | EPO - NON PEBB/OEBB | $106.70 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL OutpatientFacility | PROVIDENCE | INDIVIDUAL-STANDARD | $106.70 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL BothFacility | CIGNA | ALL PRODUCTS | $106.70 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL BothFacility | HEALTHNET | ALL PRODUCTS | $106.70 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | HEALTHNET | ALL PRODUCTS | $106.70 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL OutpatientFacility | PROVIDENCE | EPO - NON PEBB/OEBB | $106.70 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL OutpatientFacility | PROVIDENCE | EPO - PEBB/OEBB | $106.70 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | PROVIDENCE | INDIVIDUAL-STANDARD | $106.70 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | PROVIDENCE | EPO - NON PEBB/OEBB | $106.70 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | CIGNA | ALL PRODUCTS | $106.70 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| GOOD SAMARITAN REGIONAL MEDICAL CENTER BothFacility | HUMANA | ALL PRODUCTS | $107.25 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | HUMANA | ALL PRODUCTS | $107.25 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN ALBANY GENERAL HOSPITAL BothFacility | HUMANA | ALL PRODUCTS | $107.25 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL BothFacility | HUMANA | ALL PRODUCTS | $107.25 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL BothFacility | HUMANA | ALL PRODUCTS | $107.25 | $110.00 | $88.00 | 2026-01-31 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | Blue Shield | Medicare Advantage | $2,057.76 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | Aetna Medicare | Medicare | $2,057.76 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | SCAN | Medicare | $2,566.69 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | LA care Medi-Cal HMO | Medi-Cal HMO | $3,311.51 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| RANDOLPH HOSPITAL Both | Medcost | — | — | $26,958.30 | — | 2026-07-15 | MRF ↗ |
| RANDOLPH HOSPITAL Both | Mcr Bcbs Blue Mcr | — | $3,391.91 | $26,958.30 | — | 2026-07-15 | MRF ↗ |
| RANDOLPH HOSPITAL Both | Ppc | — | — | $26,958.30 | — | 2026-07-15 | MRF ↗ |
| RANDOLPH HOSPITAL Both | Mcr Uhc | — | $3,391.91 | $26,958.30 | — | 2026-07-15 | MRF ↗ |
| RANDOLPH HOSPITAL Both | Mcr Health Team Advantage | — | $3,391.91 | $26,958.30 | — | 2026-07-15 | MRF ↗ |
| RANDOLPH HOSPITAL Both | Mcr | — | $3,391.91 | $26,958.30 | — | 2026-07-15 | MRF ↗ |
| RANDOLPH HOSPITAL Both | Mcr Humana | — | $3,391.91 | $26,958.30 | — | 2026-07-15 | MRF ↗ |
| RANDOLPH HOSPITAL Both | Mcr Wellcare | — | $3,459.75 | $26,958.30 | — | 2026-07-15 | MRF ↗ |
| RANDOLPH HOSPITAL Both | Mcr Cigna | — | $3,459.75 | $26,958.30 | — | 2026-07-15 | MRF ↗ |
| RANDOLPH HOSPITAL Both | Mcr Aetna | — | $3,459.75 | $26,958.30 | — | 2026-07-15 | MRF ↗ |
| HOLZER MEDICAL CENTER Both | Aetna Medicare | Hmo | $3,482.15 | $47,868.00 | $23,933.86 | 2026-07-15 | MRF ↗ |
| HOLZER MEDICAL CENTER Both | United Healthcare Medicare | Ppo | $3,482.15 | $47,868.00 | $23,933.86 | 2026-07-15 | MRF ↗ |
| HOLZER MEDICAL CENTER Both | United Healthcare Medicare | Hmo | $3,482.15 | $47,868.00 | $23,933.86 | 2026-07-15 | MRF ↗ |
| HOLZER MEDICAL CENTER Both | Medical Mutual Medicare | Mcradv | $3,482.15 | $47,868.00 | $23,933.86 | 2026-07-15 | MRF ↗ |
| HOLZER MEDICAL CENTER Both | Anthem Medicare | Hmo | $3,482.15 | $47,868.00 | $23,933.86 | 2026-07-15 | MRF ↗ |
| HOLZER MEDICAL CENTER Both | Wv Senior Adv | Isnp | $3,482.15 | $47,868.00 | $23,933.86 | 2026-07-15 | MRF ↗ |
| HOLZER MEDICAL CENTER Both | Valor Health Plans | Isnp | $3,482.15 | $47,868.00 | $23,933.86 | 2026-07-15 | MRF ↗ |
| HOLZER MEDICAL CENTER Both | Aetna Medicare | Ppo | $3,482.15 | $47,868.00 | $23,933.86 | 2026-07-15 | MRF ↗ |
| HOLZER MEDICAL CENTER Both | The Health Plan Medicare | Securecare | $3,482.15 | $47,868.00 | $23,933.86 | 2026-07-15 | MRF ↗ |
| HOLZER MEDICAL CENTER Both | Humana Medicare | Trad | $3,482.15 | $47,868.00 | $23,933.86 | 2026-07-15 | MRF ↗ |
| HOLZER MEDICAL CENTER Both | Humana Medicare | Ppo | $3,482.15 | $47,868.00 | $23,933.86 | 2026-07-15 | MRF ↗ |
| HOLZER MEDICAL CENTER Both | Aetna Medicare | Wvdsnp | $3,482.15 | $47,868.00 | $23,933.86 | 2026-07-15 | MRF ↗ |
| HOLZER MEDICAL CENTER Both | Buckeye Medicare | Wellcare | $3,482.15 | $47,868.00 | $23,933.86 | 2026-07-15 | MRF ↗ |
| HOLZER MEDICAL CENTER Both | Anthem Medicare | Ppo | $3,482.15 | $47,868.00 | $23,933.86 | 2026-07-15 | MRF ↗ |
| HOLZER MEDICAL CENTER Both | Humana Medicare | Pos | $3,482.15 | $47,868.00 | $23,933.86 | 2026-07-15 | MRF ↗ |
| HOLZER MEDICAL CENTER Both | Ohio Medicare | Trad | $3,482.15 | $47,868.00 | $23,933.86 | 2026-07-15 | MRF ↗ |
| HOLZER MEDICAL CENTER Both | United Healthcare Medicare | Duals | $3,482.15 | $47,868.00 | $23,933.86 | 2026-07-15 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Monarch | Medicare | $3,482.15 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | LA Care DSNP | Medicare HMO | $3,482.15 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | UHC Mediare Advantage | Medicare Advantage | $3,482.15 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| RANDOLPH HOSPITAL Both | Mcr Devoted Healthcare | — | $3,527.59 | $26,958.30 | — | 2026-07-15 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Anthem Vivity, Anthem HMO | HMO-NonCity of LA | $3,550.05 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Anthem Vivity-Anthem HMO | All Products-HMO | $3,550.05 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| RANDOLPH HOSPITAL Both | Mcr Liberty | — | $3,595.43 | $26,958.30 | — | 2026-07-15 | MRF ↗ |
| RANDOLPH HOSPITAL Both | Mcr Troy | — | $3,595.43 | $26,958.30 | — | 2026-07-15 | MRF ↗ |
| RANDOLPH HOSPITAL Both | Mcr Apex | — | $3,595.43 | $26,958.30 | — | 2026-07-15 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Blue Shield | Medicare Advantage | $3,660.83 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | St. Jude | Medicare HMO | $3,768.80 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Redlands Community Medicare | Medicare | $3,768.80 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | TriWest Healthcare Alliance | Other Government | $3,768.80 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Aetna Medicare | Medicare | $3,768.80 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Health Plan of Nevada Medicare | Medicare | $3,768.80 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | TriWest Healthcare Alliance | Other Government | $3,768.80 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | UCLA Health Medicare Advantage Plan | Medicare Advantage | $3,768.80 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | UCLA Health Medicare Advantage Plan | Medicare Advantage | $3,768.80 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | Blue Shield | All Products | $3,827.86 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Providence Healthcare | Medicare | $3,830.37 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Torrance Memorial Medicare | HMO-Medicare | $3,830.37 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Blue Shield | All Products | $3,919.73 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Blue Shield | EPN | $3,919.73 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | Blue Shield | EPN | $3,919.73 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Central Health Plan | Medicare HMO | $4,045.30 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | HealthSmart | Workers Compensation | $4,522.56 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | SCAN | Medicare | $4,700.90 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | LA Care Covered CA | HMO | $4,719.51 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| RANDOLPH HOSPITAL Both | Cigna | Hmo & Ppo | $4,782.60 | $26,958.30 | — | 2026-07-15 | MRF ↗ |
| HOLZER MEDICAL CENTER Both | Caresource Exchange | Hmo | $4,875.01 | $47,868.00 | $23,933.86 | 2026-07-15 | MRF ↗ |
| ENGLEWOOD HOSPITAL AND MEDICAL CENTER InpatientFacility | MagnaCare_770 | IDN Network | $5,000.00 | $402,495.02 | $40,249.50 | 2026-02-02 | MRF ↗ |
| ENGLEWOOD HOSPITAL AND MEDICAL CENTER InpatientFacility | MagnaCare_768 | Create Flex | $5,000.00 | $402,495.02 | $40,249.50 | 2026-02-02 | MRF ↗ |
| RANDOLPH HOSPITAL Both | Medcost | Ultra | $5,391.66 | $26,958.30 | — | 2026-07-15 | MRF ↗ |
| RANDOLPH HOSPITAL Both | Ncsehp | — | $7,971.00 | $26,958.30 | — | 2026-07-15 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Centivo | PPO | $9,045.12 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| HOLZER MEDICAL CENTER Both | Ohiohealth | Ohiohealthypremier | $9,573.54 | $47,868.00 | $23,933.86 | 2026-07-15 | MRF ↗ |
| HOLZER MEDICAL CENTER Both | Ohiohealth | Ohiohealthy | $9,573.54 | $47,868.00 | $23,933.86 | 2026-07-15 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Health Plan of Nevada Commercial | All Products | $10,401.89 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Optum | Medicare | $10,816.46 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Blue Shield | EPN | $11,961.00 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| HOLZER MEDICAL CENTER Both | Caresource Medicaid | Hmo | $12,484.93 | $47,868.00 | $23,933.86 | 2026-07-15 | MRF ↗ |
| HOLZER MEDICAL CENTER Both | Ohio Medicaid | Trad | $12,484.93 | $47,868.00 | $23,933.86 | 2026-07-15 | MRF ↗ |
| HOLZER MEDICAL CENTER Both | The Health Plan Medicaid | Hmo | $12,484.93 | $47,868.00 | $23,933.86 | 2026-07-15 | MRF ↗ |
| HOLZER MEDICAL CENTER Both | Unison Medicaid | Hmo | $12,859.48 | $47,868.00 | $23,933.86 | 2026-07-15 | MRF ↗ |
| HOLZER MEDICAL CENTER Both | Molina Medicaid | Hmo | $12,859.48 | $47,868.00 | $23,933.86 | 2026-07-15 | MRF ↗ |
| HOLZER MEDICAL CENTER Both | Aetna Medicaid | Hmo | $13,109.18 | $47,868.00 | $23,933.86 | 2026-07-15 | MRF ↗ |
| HOLZER MEDICAL CENTER Both | Buckeye Medicaid | Hmo | $13,109.18 | $47,868.00 | $23,933.86 | 2026-07-15 | MRF ↗ |
| HOLZER MEDICAL CENTER Both | Paramount Medicaid | Hmo | $13,109.18 | $47,868.00 | $23,933.86 | 2026-07-15 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Blue Shield | All Products | $15,948.00 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| HOLZER MEDICAL CENTER Both | Ohiohealth | Ohiouniv | $16,753.70 | $47,868.00 | $23,933.86 | 2026-07-15 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | UCLA Health Medicare Advantage Plan | Medicare Advantage | $16,951.50 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Aetna Medicare | Medicare | $16,951.50 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Gold Coast Health Plan | HMO | $18,985.68 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Gold Coast Health Plan | HMO | $18,985.68 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Anthem Workers Comp | Workers Comp | $19,453.54 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | Anthem Vivity, Anthem HMO | HMO-City of LA | $19,873.94 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Anthem Vivity, Anthem HMO | HMO-City of LA | $22,050.51 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | UC Care - PPO | PPO | $22,240.37 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | UC Ship | PPO | $22,782.82 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | UC Ship | PPO | $22,782.82 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Providence Healthcare | Medicare | $23,732.10 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Health Care LA - RMG | All Products | $23,732.10 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | CenCal Transplant Medi-Cal HMO | Medi-Cal HMO | $23,732.10 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | CenCal Medi-Cal HMO | Medi-Cal HMO | $23,732.10 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Health Care LA MediCal - RMG | Medicaid Advantage | $23,732.10 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Health Care LA - RMG | All Products | $23,732.10 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Blue Shield | Medicare Advantage | $23,732.10 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Health Care LA MediCal - RMG | Medicaid Advantage | $23,732.10 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| HOLZER MEDICAL CENTER JACKSON Both | Anthem Exchange | Pathway X Hmo | $24,077.46 | $47,867.72 | $23,933.86 | 2026-07-15 | MRF ↗ |
| HOLZER MEDICAL CENTER Both | Anthem Exchange | Hmo | $24,125.33 | $47,868.00 | $23,933.86 | 2026-07-15 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Anthem Vivity, Anthem HMO | HMO-NonCity of LA | $24,844.12 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | Anthem Vivity, Anthem HMO | HMO-NonCity of LA | $24,844.12 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| HOLZER MEDICAL CENTER JACKSON Both | Anthem Exchange | Pathway X Ppo | $25,369.89 | $47,867.72 | $23,933.86 | 2026-07-15 | MRF ↗ |
| HOLZER MEDICAL CENTER Both | Anthem Exchange | Ppo | $25,417.76 | $47,868.00 | $23,933.86 | 2026-07-15 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | Molina MI Health Link | MEDICARE ADVANTAGE | $26,388.42 | $87,961.40 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | MOLINA | MARKETPLACE | $26,388.42 | $87,961.40 | — | 2025-06-28 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | UC Care - PPO | PPO | $26,512.15 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Children Hospital of Orange County | Medicaid HMO | $27,122.40 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Molina Healthcare HMO | MediCal HMO | $27,122.40 | $67,806.00 | $37,293.30 | 2026-03-29 | MRF ↗ |
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